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中华肝脏外科手术学电子杂志 ›› 2025, Vol. 14 ›› Issue (01) : 68 -73. doi: 10.3877/cma.j.issn.2095-3232.2025014

临床研究

光动力疗法在晚期胆管癌姑息性治疗中的安全性和疗效Meta 分析
董思帆1, 安仕琪1, 刘起帆1, 王楚风1, 蒋安1,()   
  1. 1.710004 西安交通大学第二附属医院肝胆胰与肝移植外科
  • 收稿日期:2024-10-21 出版日期:2025-02-10
  • 通信作者: 蒋安

Safety and efficacy of photodynamic therapy in palliative treatment of advanced cholangiocarcinoma:a Meta-analysis

Sifan Dong1, Shiqi An1, Qifan Liu1, Chufeng Wang1, An Jiang1,()   

  1. 1.Department of Hepatobiliary Pancreas and Liver Transplantation Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004, China
  • Received:2024-10-21 Published:2025-02-10
  • Corresponding author: An Jiang
引用本文:

董思帆, 安仕琪, 刘起帆, 王楚风, 蒋安. 光动力疗法在晚期胆管癌姑息性治疗中的安全性和疗效Meta 分析[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(01): 68-73.

Sifan Dong, Shiqi An, Qifan Liu, Chufeng Wang, An Jiang. Safety and efficacy of photodynamic therapy in palliative treatment of advanced cholangiocarcinoma:a Meta-analysis[J/OL]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2025, 14(01): 68-73.

目的

系统评价光动力疗法(PDT)在晚期胆管癌姑息性治疗中的安全性和疗效。

方法

计算机检索 PubMed、SCI、中国知网和万方数据库,收集 2005 年1 月1 日至2023 年1 月30 日公开发表的有关PDT、姑息性切除、单纯支架置入的治疗晚期胆管癌研究论文。采用RevMan 5.3 软件进行 Meta 分析。

结果

共纳入14 篇文献,其中12 篇共871 例纳入PDT 和支架引流分析,2 篇共159 例研究纳入PDT 和姑息性切除分析。Meta 分析显示,与支架引流组相比,PDT 组总并发症(OR=0.87,95%CI:0.40~1.90)、胆管炎发生率(OR=1.34,95%CI:0.80~2.25)差异无统计学意义(P>0.05);PDT 组术后1、2、3 年生存率(OR=4.78,95%CI:2.02~11.33;OR=2.80,95%CI:1.35~5.78;OR=3.75,95%CI:1.09~12.93),PDT 组中位生存时间(OR=6.23,95%CI:6.07~6.40)均有明显优势(P<0.05)。而PDT 组与姑息性切除组1 年生存率(OR=0.69,95%CI:0.34~1.38)、3 年生存率(OR=0.60,95%CI:0.27~1.34)差异无统计学意义(P>0.05)。

结论

对于晚期胆管癌姑息治疗患者,PDT 能改善患者生存,与姑息性切除疗效相当,且具有安全、恢复快、创伤性小、多次使用优势,是一种具有前景的治疗方式。

Objective

To systematically evaluate the safety and efficacy of photodynamic therapy

(PDT) in palliative treatment of advanced cholangiocarcinoma.

Methods

Studies related to PDT, palliative resection and simple stent implantation for advanced cholangiocarcinoma published from January 1, 2005 to January 30, 2023 were searched from PubMed, SCI, CNKI and Wanfang databases.Meta-analysis was carried out by RevMan 5.3 software.

Results

A total of 14 studies were included, including 12 studies consisting of 871 patients receiving PDT and stent drainage, and 2 studies comprising 159 cases undergoing PDT and palliative resection.Meta-analysis showed that compared with the stent drainage group, the incidence of overall complications (OR=0.87, 95%CI: 0.40-1.90) and cholangitis (OR=1.34, 95%CI: 0.80-2.25) had no statistical significance in the PDT group (both P>0.05).Compared with the stent drainage group, the 1-, 2- and 3-year survival rates (OR=4.78, 95%CI: 2.02-11.33; OR=2.80, 95%CI: 1.35-5.78; OR=3.75, 95%CI: 1.09-12.93),and the median survival (OR=6.23, 95%CI: 6.07-6.40) were significantly better in the PDT group (all P<0.05).However, there were no significant differences in 1-year (OR=0.69, 95%CI: 0.34-1.38) and 3-year survival rates (OR=0.60, 95%CI: 0.27-1.34) between the PDT and palliative resection groups (both P>0.05).

Conclusions

PDT can improve the survival of patients with advanced cholangiocarcinoma receiving palliative treatment.PDT yields equivalent efficacy to palliative resection and has multiple advantages of safety, rapid recovery, mild trauma and repeated use, which is a promising treatment for advanced cholangiocarcinoma.

表1 PDT 与单纯支架置入比较的文献基本特征
表2 PDT 与姑息性切除比较的文献基本特征
图1 文献筛选流程 注:SCI 为科学引文索引
图2 PDT 组与单纯支架置入组中位生存时间比较Meta 亚组分析的森林图 注:PDT 为光动力疗法
图3 PDT 组与单纯支架置入组3 年生存率比较Meta 分析的森林图 注:PDT 为光动力疗法
图4 纳入PDT 与支架引流比较研究文献的敏感性分析 注:PDT 为光动力疗法
图5 纳入PDT 与支架引流比较研究文献的漏斗图 注:PDT 为光动力疗法
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