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A meta-analysis of the efficacy of postoperative adjuvant radiotherapy and non-radiotherapy for extrahepatic cholangiocarcinoma and gallbladder carcinoma
Ren Bixin, Liu lei, Yang Yongqiang, Guo Qi, Zhang Liyuan, Tian Ye
Department of Radiotherapy & Oncology,Second Affiliated Hospital of Soochow University,Institute of Radiotherapy & Oncology,Soochow University,Suzhou Key Laboratory for Radiation Oncology,Suzhou 215004,China
AbstractObjective To compare the efficacy of postoperative adjuvant radiotherapy and non-radiotherapy in patients with extrahepatic cholangiocarcinoma and gallbladder carcinoma by a meta-analysis. Methods The controlled clinical trials of postoperative adjuvant radiotherapy versus non-radiotherapy of extrahepatic cholangiocarcinoma and gallbladder carcinoma were searched from PubMed, EMbase, Cochrane Library, Wanfang database, CNKI, Chongqing VIP and CBM databases. The obtained data were analyzed using RevMan 5.3 and Stata 14.0 statistical software. The difference between two groups was estimated by calculating the odds ratio (OR) with 95% confidence interval (CI). Results A total of 20 controlled clinical trials involving 1258 extrahepatic cholangiocarcinoma and gallbladder carcinoma patients were included in this meta-analysis. The meta-analysis demonstrated that the 5-year survival rate in the adjuvant radiotherapy group was significantly higher than that in the non-radiotherapy group (OR=1.67, 95%CI:1.29-2.18, P=0.001). The 5-year survival rates in those with lymph node positive disease (OR=7.44, 95%CI:1.24-44.72, P=0.03) and positive margins disease (OR=3.43,95%CI:1.56-7.75,P=0.002) were significantly enhanced by postoperative adjuvant radiotherapy. The local recurrence rate in the adjuvant radiotherapy group was significantly lower than that in the non-radiotherapy group (OR=0.56,95%CI:0.39-0.80,P=0.01), whereas the distant metastasis rate did not significantly differ between two groups (OR=1.22,95%CI:0.86-1.73,P=0.27). The incidence rates of acute toxicity and chronic toxicity of grade ≥3 caused by radiotherapy were 0-11.9% and 0-21.7%,respectively. Conclusion Compared with non-radiotherapy, postoperative adjuvant radiotherapy is a safer and more effective postoperative treatment for extrahepatic cholangiocarcinoma and gallbladder carcinoma.
Fund:Jiangsu Provincial Special Program of Clinical Medical Science (BE2018657);Jiangsu Province Medical Innovation Team Class A (CXDT-37);Suzhou Clinical Medical Center Construction Project (Szzxj201503);Medicine Outstanding Leader of Suzhou (62)
Ren Bixin,Liu lei,Yang Yongqiang et al. A meta-analysis of the efficacy of postoperative adjuvant radiotherapy and non-radiotherapy for extrahepatic cholangiocarcinoma and gallbladder carcinoma[J]. Chinese Journal of Radiation Oncology, 2019, 28(11): 836-839.
Ren Bixin,Liu lei,Yang Yongqiang et al. A meta-analysis of the efficacy of postoperative adjuvant radiotherapy and non-radiotherapy for extrahepatic cholangiocarcinoma and gallbladder carcinoma[J]. Chinese Journal of Radiation Oncology, 2019, 28(11): 836-839.
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