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CLC number: R735.8

On-line Access: 2024-08-27

Received: 2023-10-17

Revision Accepted: 2024-05-08

Crosschecked: 2020-06-05

Cited: 0

Clicked: 2887

Citations:  Bibtex RefMan EndNote GB/T7714

 ORCID:

Ai-lin Li

https://orcid.org/0000-0002-5526-8392

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Journal of Zhejiang University SCIENCE B 2020 Vol.21 No.7 P.549-559

http://doi.org/10.1631/jzus.B1900691


Role of adjuvant (chemo)radiotherapy for resected extrahepatic cholangiocarcinoma: a meta-analysis


Author(s):  Xin-qi Shi, Jing-yu Zhang, Hua Tian, Ling-na Tang, Ai-lin Li

Affiliation(s):  Department of Radiation Oncology, the First Hospital of China Medical University, Shenyang 110001, China

Corresponding email(s):   liailin0312@163.com

Key Words:  Adjuvant (chemo)radiotherapy, Extrahepatic cholangiocarcinoma, Meta-analysis, Disease-free survival, Overall survival


Xin-qi Shi, Jing-yu Zhang, Hua Tian, Ling-na Tang, Ai-lin Li. Role of adjuvant (chemo)radiotherapy for resected extrahepatic cholangiocarcinoma: a meta-analysis[J]. Journal of Zhejiang University Science B, 2020, 21(7): 549-559.

@article{title="Role of adjuvant (chemo)radiotherapy for resected extrahepatic cholangiocarcinoma: a meta-analysis",
author="Xin-qi Shi, Jing-yu Zhang, Hua Tian, Ling-na Tang, Ai-lin Li",
journal="Journal of Zhejiang University Science B",
volume="21",
number="7",
pages="549-559",
year="2020",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B1900691"
}

%0 Journal Article
%T Role of adjuvant (chemo)radiotherapy for resected extrahepatic cholangiocarcinoma: a meta-analysis
%A Xin-qi Shi
%A Jing-yu Zhang
%A Hua Tian
%A Ling-na Tang
%A Ai-lin Li
%J Journal of Zhejiang University SCIENCE B
%V 21
%N 7
%P 549-559
%@ 1673-1581
%D 2020
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1900691

TY - JOUR
T1 - Role of adjuvant (chemo)radiotherapy for resected extrahepatic cholangiocarcinoma: a meta-analysis
A1 - Xin-qi Shi
A1 - Jing-yu Zhang
A1 - Hua Tian
A1 - Ling-na Tang
A1 - Ai-lin Li
J0 - Journal of Zhejiang University Science B
VL - 21
IS - 7
SP - 549
EP - 559
%@ 1673-1581
Y1 - 2020
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B1900691


Abstract: 
Background: adjuvant (chemo)radiotherapy (A(C)RT) may be an important supplement to surgery for extrahepatic cholangiocarcinoma (EHCC). However, whether all patients would achieve benefits from A(C)RT and which adjuvant regimen, adjuvant radiotherapy (ART) or adjuvant chemoradiotherapy (ACRT), would be preferred, are still undetermined. The low incidence of EHCC makes it difficult to carry out randomized controlled trials (RCTs); therefore, almost all clinical studies on radiotherapy are retrospective. We have conducted a meta-analysis of these retrospective studies. Methods: We conducted a meta-analysis of current retrospective studies using PubMed, Embase, and ClinicalTrials databases. All studies published in English that were related to A(C)RT and which analyzed overall survival (OS), disease-free survival (DFS), or locoregional recurrence-free survival (LRFS) were included. Estimated hazard ratios (HRs) were calculated for OS, DFS, and LRFS. Results: Data from eight studies including 685 patients were included. Our analysis showed that A(C)RT significantly improved OS (HR 0.69, 95% confidence interval (CI) 0.48–0.97, P=0.03), DFS (HR 0.60, 95% CI 0.47–0.76, P<0.0001), and LRFS (HR 0.27, 95% CI 0.17–0.41, P<0.00001) of EHCC overall. In subgroups, patients with microscopically positive resection margin (R1) could achieve a benefit from A(C)RT (HR 0.44, 95% CI 0.27–0.72, P=0.001). No statistically OS difference was observed in negative resection margin (R0) subgroup (HR 0.98, 95% CI 0.30–3.19, P=0.98).Significant OS benefit was found in patients who received concurrent ACRT (HR 0.40, 95% CI 0.26–0.62, P<0.0001), while the result of ART without chemotherapy showed no significant benefit (HR 1.14, 95% CI 0.29–4.50, P=0.85). In the distal cholangiocarcinoma subgroup, no significant difference was seen when ACRT and ART were included (HR 0.61, 95% CI 0.14–2.72, P=0.52), but a significant difference was seen when analyzing the concurrent ACRT only (HR 0.29, 95% CI 0.13–0.64, P=0.002). Conclusions: A(C)RT may improve OS, DFS, and LRFS in EHCC patients, especially in those with R1 resection margins. ACRT may be superior to ART especially in distal patients.

辅助放(化)疗在肝外胆管细胞癌中的作用:荟萃分析

目的:分析术后辅助放(化)疗在肝外胆管细胞癌中的作用,找到具体哪些临床亚组能从辅助放(化)疗中获益.
创新点:本研究报告了辅助放(化)疗可以改善肝外胆管细胞癌患者尤其是显微镜下切缘阳性患者的总生存期、无病生存期和无转移生存期,为这一无定论的临床问题提供循证证据.
方法:我们检索了截至2019年10月,收录在PubMed、Embase和ClinicalTrials三个数据库中关于术后辅助放(化)疗在肝外胆管细胞癌中的作用的文献.经过筛选,最终有8篇文献符合纳入标准,并采用RevMan软件进行数据分析.
结论:辅助放(化)疗可以改善肝外胆管细胞癌患者的总生存期、无病生存期和无转移生存期,尤其是在显微镜下阳性切缘的患者中. 辅助同步放化疗可能优于单纯辅助放疗,尤其是在远端胆管癌患者中.

关键词:辅助放(化)疗;肝外胆管细胞癌;荟萃分析;无病生存期;总生存期

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

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[37]https://doi.org/10.21873/anticanres.13785

[38]List of electronic supplementary materials

[39]Table S1 Characteristics of the included studies

[40]Table S2 Newcastle-Ottawa Scale (NOS) for quality assessment of non-randomized studies in the meta-analysis (cohort studies)

[41]Table S3 Toxicities (CTCAE Version 3.0) reported in the selected studies

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