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CLC number: R735.8

On-line Access: 2020-07-07

Received: 2019-12-08

Revision Accepted: 2020-03-20

Crosschecked: 2020-06-05

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Citations:  Bibtex RefMan EndNote GB/T7714


Ai-lin Li


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


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.

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author="Xin-qi Shi, Jing-yu Zhang, Hua Tian, Ling-na Tang, Ai-lin Li",
journal="Journal of Zhejiang University Science B",
publisher="Zhejiang University Press & Springer",

%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

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

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.


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.


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


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[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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