To evaluate the efficacy and safety of transarterial radioembolization (TARE) in the treatment of unresectable intrahepatic cholangiocarcinoma (ICC).

All literature in English related to TARE in the treatment of unresectable ICC were searched from PubMed, Embase and Cochrane Library databases. Literature search was carried out using subject words and free words, and the searching words were cholangiocarcinoma, cholangiocellular carcinoma, unresectable, advanced, TARE and transarterial radioembolization, etc. The retrieval time was from the database inception date to April 1, 2022. The main index was objective remission rate (ORR) and the secondary indexes were the 1-, 2- and 3-year survival rate and incidence of adverse reactions. Meta-analysis was performed by Stata 12.0 software.

A total of 739 patients from 18 studies were included for Meta-analysis. Meta-analysis revealed that the ORR of TARE for unresectable ICC was 20.5%. The ORR in the Yttrium-90 resin microsphere group was 22.9%, and was 20.5% in the Yttrium-90 glass microsphere group, where no significant difference was observed (χ²=0.10, P=0.75). In the good physical condition group, the ORR was calculated as 22.3% and 12.4% in the poor physical condition group, and no significant difference was observed (χ²=2.05, P=0.15). The 1-, 2- and 3-year survival rates of patients treated with TARE were 39.8%, 17.9% and 5.5%, respectively. Fatigue was the most common adverse reaction after TARE with an incidence of 39%. The major severe adverse reactions consisted of liver failure (3.2%) and peptic ulcer (2.9%).

TARE yields acceptable clinical efficacy and low incidence of severe adverse reactions in patients with unresectable ICC.