Meta-analysis Of Oeffect And Safety Of Photodynamic Therapy Combined With Stent And Stent Alone In Unresectable Cholangiocarcinoma

Objectives:The main purpose of the study was to explore the effect and safety of PDT on the survival of patients with unresectable cholangiocarcinoma.Methods:The related literatures on the treatment of unresectable cholangiocarcinoma with PDT in the Cochrane Library,Pub Med,Embase,CNKI,Wanfang Data were comprehensively searched.Cochrane manual standard was used to evaluate the quality of included RCT studies.NOS scale was used to evaluate the quality of included cohort studies.Using Review Manager 5.3 softwares for Meta analysis.Between-study statistical heterogeneity was assessed using I~2.A fixed-effects model was used unless I~2was>50%,indicating a substantial level of between study heterogeneity which case a random-effects model was used.The outcome indicators were overall survival time,1-year survival rate,adverse events rate.Funnel Chart was used to detect publication bias.Results:A total of 14 articles were included in this study,including 3randomized controlled studies and 11 cohort studies.A total of 873patients with,including 405 patients in the PDT group and 468 patients in the control group.1.Overall Survival Results:A total of 14 studies were included.Meta analysis showed that the Overall Survival of the PDT group was better than that of the control group,which was statistically significant(MD=5.94,95%CI:3.89～8.00,P<0.00001).The results of subgroup analysis showed that the Overall Survival of the PDT group was significantly longer than the stent group regardless of metal or plastic,which plastic stent group results:MD=7.15,95%CI:3.41～10.89,P=0.0002,and material stent group results:MD=2.94,95%CI:1.46～4.41,P<0.0001.2.The analysis results of 1-year survival rate showed that the survival rate of the PDT group was higher than that of the control group(RR=2.39,95%CI:1.45～3.96,P=0.0007).3.A total of 12 studies were included.The analysis results of overall adverse events rate showed that no significant difference between the PDT group and the control group(RR=1.16,95%CI:0.94～1.44,P=0.17).Conclusions:PDT can improve the overall survival,and 1-year survival rate in patients with cholangiocarcinoma.No matter what kind of stent(metal or plastic)is used,patients can benefit from PDT without increasing the incidence of adverse events rate.But a large number of high-quality RCT studies are still needed to confirm this view.