Conventional and drug‑eluting bead transarterial chemoembolization in patients with inoperable intrahepatic cholangiocarcinoma: a meta‑analysis

Abstract

Introduction: In patients with inoperable intrahepatic cholangiocarcinoma (ICC), both conventional transarterial chemoembolization (cTACE) and drug-eluting bead TACE (DEB-TACE) can be employed as therapeutic interventions. However, the relative advantages of these strategies remain to be clarified. Aim: This meta-analysis was performed to compare the safety and efficacy of DEB-TACE and cTACE in the treatment of ICC. Materials and methods: A comprehensive search of the Cochrane Library, PubMed, and Wanfang databases was conducted to identify publications that were pertinent to the present meta-analysis. The primary outcome of interest was the overall survival (OS) rate. Secondary outcomes were progression-free survival (PFS), disease control rate (DCR), objective response rate (ORR), and adverse event (AE) rate. Heterogeneity was evaluated using the I2 statistic, while publication bias was assessed with the Egger test. Results: A total of 6 articles involving 283 and 178 patients who received cTACE and DEB-TACE treatment, respectively, were included in this study. DEB-TACE was superior to cTACE in terms of DCR (P = 0.004), PFS (P <⁠0.001), and OS (P = 0.004), despite comparable pooled ORRs. No intergroup differences were observed with respect to AE occurrence. The ORR, DCR, and OS end points showed significant heterogeneity (I2 = 79%, I2 = 61%, and I2 = 95%, respectively). Additionally, the OS end point was subject to substantial publication bias (Egger test, P = 0.002). Conclusions: DEB-TACE was shown to be superior to cTACE with respect to efficacy, while the safety profile of these 2 interventions was similar. Consequently, DEB-TACE offers additional value in the management of inoperable ICC.

Keywords

• conventional
• drug-eluting beads
• intrahepatic cholangiocarcinoma
• transarterial chemoembolization