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

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 pri- mary 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 I-2 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 (I-2 = 79%, I-2 = 61%, and I-2 = 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 man- agement of inoperable ICC.