Objective: Current meta-analysis was performed to systematically evaluate the survival outcomes and tumor response of hepatic arterial infusion chemotherapy (HAIC) for unresectable intrahepatic cholangiocarcinoma (iCCA). Method: A literature search was conducted using PubMed, Medline (Ovid), Scopus, Embase, Web of Science, and the Cochrane Library databases. The primary outcomes were overall survival and progression-free survival (PFS) expressed as hazard ratios (HRs) with 95% confidence intervals (CIs). The secondary outcomes were response rates. Result: Nine retrospective cohort studies with 1259 patients were identified. The overall analysis demonstrated a significant reduction in mortality following HAIC (HR = 0.49, 95% CI: 0.35–0.62; I 2 = 65.3%, P = 0.003). All subgroup analyses demonstrated statistically significant HRs, and subgroup studies focusing on extrahepatic metastasis demonstrated minimal heterogeneity ( I 2 = 0, P = 0.792 and I 2 = 0, P = 0.508). Six studies reported the median PFS and provided Kaplan–Meier curves of both groups. The overall analysis demonstrated a significant reduction in disease progression following HAIC (HR = 0.56, 95% CI: 0.37–0.75; I 2 = 54.0%, P = 0.054). In six studies that reported objective response rate (ORR), we found higher ORR in the HAIC group than that in the systemic chemotherapy (SC) group (RR 2.26, 95% CI: 1.78–2.88; I 2 = 25.4%, P = 0.244). In six studies that reported disease control rate (DCR), we found higher DCR in the HAIC group than that in the SC group (RR 1.27, 95% CI: 1.07–1.50; I 2 = 68.7%, P = 0.012). Conclusion: This meta-analysis demonstrated that HAIC is associated with a significantly reduced risk of mortality and disease progression in patients with unresectable iCCA. HAIC is also associated with higher tumor response rates compared to SC in unresectable iCCA.
Xi et al. (Wed,) studied this question.