Efficacy and Safety of 125I Seed Brachytherapy Combined with Gemcitabine Containing Chemotherapy for Unresectable Pancreatic Neoplasm—A Meta-Analysis

Abstract

These instructions provide you guidelines for preparing papers for Journal of Innovation and Social Science Research. Use this document as a template and as an instruction set. PURPOSE: The goal of this meta-analysis was to look at the efficacy and safety of radioactive seeds brachytherapy using Iodine-125 for unresectable advanced pancreatic neoplasm. METHODS AND MATERIALS: In pancreatic neoplasm, trials comparing 125I brachytherapy with Gemcitabine chemotherapy have been identified. The pooled odds ratios for overall response rate (ORR), disease control rate (DCR), and complications, as well as the pooled hazard ratios for progression free survival (PFS) and overall survival, were calculated using meta-analysis (OS). RESULTS: A total of 12 studies with a total of 863 cases were included. There were significant differences in ORR (OR=3.13, 95% CI 2.24-4.38) and DCR (OR=3.67, 95% CI 2.63-5.12) between 125I brachytherapy combined with chemotherapy containing gemcitabine and chemotherapy alone, but no statistical differences in PFS (HR=0.63, 95% CI 0.30-1.32), OS (HR=0.72, 95 %CI 0.43-1.20), and adverse reactions (diarrhea: OR=0.75, 95%CI: 0.42-1.25; pernicious vomiting: OR=1.30, 95%CI: 0.82-2.06; leukopenia: OR=1.32, 95%CI: 0.88-1.98; thrombocytopenia: OR=1.05, 95%CI: 0.71-1.57; anemia: OR=1.18, 95%CI: 0.66-2.10; and hepatic impairment: OR=1.10. 95% CI: 0.63-1.92). CONCLUSION: 125I brachytherapy combined with the inclusion of gemcitabine chemotherapy enhance the clinical efficacy of patients with unresectable pancreatic neoplasm without increasing the incidence of adverse effects such as pancreatic fistula, pancreatitis, seed migration, and duodenitis compared with chemotherapy. However, there was no obvious effect on the survival of unresectable pancreatic neoplasm.