Hepatic arterial infusion chemotherapy versus transarterial chemoembolization in patients with unresectable intrahepatic cholangiocarcinoma: a multicenter retrospective cohort study.

IF 4.7 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
European Radiology Pub Date : 2025-10-01 Epub Date: 2025-04-11 DOI:10.1007/s00330-025-11557-6
Yi Zhang, Ze Zhang, Xiaoxv Yin, Anhui Xu, Yonghong Hao, Nan Jiang, Ruibing Zhou, Ketao Mu
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引用次数: 0

Abstract

Background: Patients with unresectable intrahepatic cholangiocarcinoma (ICC) have poor overall survival (OS). Hepatic arterial infusion chemotherapy (HAIC) and transarterial chemoembolization (TACE), including conventional TACE (c-TACE) and drug-eluting bead TACE (DEB-TACE), are widely used to treat ICC, but the efficacy of these therapies has not been fully demonstrated. This study aimed to compare the efficacy of HAIC and TACE in unresectable ICC patients.

Methods: This retrospective cohort study included unresectable ICC patients who received HAIC, c-TACE or DEB-TACE as initial treatment between June 2016 and October 2023 at three hospitals. The median OS (mOS), tumor response, and incidence of adverse events (AEs) were compared and propensity score matching (PSM) was used to reduce selection bias.

Results: A total of 181 patients with unresectable ICC received HAIC (n = 24), c-TACE (n = 73) and DEB-TACE (n = 84). The HAIC group had significantly higher mOS (10.3 vs. 5.1 months, p = 0.0042), objective response rate (ORR) (29.2% vs. 4.1%, p = 0.002) and disease control rate (DCR) (95.8% vs. 43.8%, p < 0.001) than the c-TACE group. There was no significant difference between the HAIC and DEB-TACE groups in improving mOS (10.3 vs. 12.5 months, p = 0.61). Results remained consistent after PSM. The c-TACE and DEB-TACE groups had a higher incidence of AEs compared with the HAIC group. After matching, there was no significant difference in the incidence of AEs between groups.

Conclusion: HAIC improves ICC patient prognosis better than c-TACE. Both HAIC and DEB-TACE are superior treatment options for unresectable ICC.

Key points: Question The evidence of comparative effectiveness between hepatic arterial infusion chemotherapy (HAIC) and transarterial chemoembolization (TACE) is insufficient. Findings HAIC significantly improved median overall survival, tumor response, and prognosis while reducing adverse events compared to convention TACE (c-TACE) in unresectable intrahepatic cholangiocarcinoma (ICC) patients. Clinical relevance HAIC significantly improves OS and tumor response in patients with unresectable ICC compared to c-TACE, but HAIC shows no significant difference from drug-eluting bead-TACE. Notably, HAIC shows no significant difference in adverse events compared to both c-TACE and DEB-TACE.

肝动脉输注化疗与经动脉化疗栓塞治疗不可切除肝内胆管癌:一项多中心回顾性队列研究
背景:不可切除的肝内胆管癌(ICC)患者的总生存期(OS)较差。肝动脉灌注化疗(HAIC)和经动脉化疗栓塞(TACE),包括常规TACE (c-TACE)和药物洗脱头TACE (DEB-TACE),被广泛用于治疗ICC,但这些疗法的疗效尚未得到充分证实。本研究旨在比较HAIC和TACE在不可切除的ICC患者中的疗效。方法:本回顾性队列研究纳入了2016年6月至2023年10月在三家医院接受HAIC、c-TACE或DEB-TACE作为初始治疗的不可切除的ICC患者。比较中位OS (mOS)、肿瘤反应和不良事件发生率(ae),并使用倾向评分匹配(PSM)来减少选择偏倚。结果:181例不可切除的ICC患者接受了HAIC (n = 24)、c-TACE (n = 73)和DEB-TACE (n = 84)。HAIC组的mOS(10.3个月vs. 5.1个月,p = 0.0042)、客观缓解率(ORR) (29.2% vs. 4.1%, p = 0.002)和疾病控制率(DCR) (95.8% vs. 43.8%)均显著高于c-TACE组。对于不可切除的ICC, HAIC和DEB-TACE都是较好的治疗选择。肝动脉输注化疗(HAIC)与经动脉化疗栓塞(TACE)疗效比较的证据不足。与常规TACE (c-TACE)相比,HAIC显著提高了不可切除肝内胆管癌(ICC)患者的中位总生存期、肿瘤反应和预后,同时减少了不良事件。临床意义:与c-TACE相比,HAIC可显著改善不可切除ICC患者的OS和肿瘤反应,但与药物洗脱头- tace相比,HAIC无显著差异。值得注意的是,与c-TACE和DEB-TACE相比,HAIC在不良事件方面没有显着差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
European Radiology
European Radiology 医学-核医学
CiteScore
11.60
自引率
8.50%
发文量
874
审稿时长
2-4 weeks
期刊介绍: European Radiology (ER) continuously updates scientific knowledge in radiology by publication of strong original articles and state-of-the-art reviews written by leading radiologists. A well balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes ER an indispensable source for current information in this field. This is the Journal of the European Society of Radiology, and the official journal of a number of societies. From 2004-2008 supplements to European Radiology were published under its companion, European Radiology Supplements, ISSN 1613-3749.
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