背景：全身化疗（SC）仍然是无法手术切除内肝外胆管癌（iCCA）的唯一一线治疗方法。近期已证实肝动脉灌注化疗（HAIC）在肝细胞癌（HCC）治疗中具有疗效。因此，我们的研究旨在调查HAIC治疗无法手术切除的iCCA患者的安全性和疗效。方法：我们以回顾性的方式研究了2016年3月至2022年3月期间接受HAIC或SC治疗的146名无法手术切除的iCCA患者。比较了HAIC组和SC组的患者结果和安全性。结果：HAIC组和SC组分别有75名和71名患者。HAIC组和SC组的中位生存期分别为18.0和17.8个月（p = 0.84）。HAIC组和SC组的中位无进展生存期分别为10.8和11.4个月（p = 0.59）。然而，与SC组相比，HAIC组具有显著较长的肝内无进展生存期（IPFS）（p = 0.035）。HAIC组和SC组的中位IPFS分别为13.7和11.4个月。根据总生存期（p = 0.047）和无进展生存期（p = 0.009），HAIC组中的单发肿瘤患者似乎获益更多。此外，HAIC组的不良事件（AEs）总发生率低于SC组。结论：我们的研究揭示了HAIC是一种对无法手术切除的iCCA安全有效的治疗方案，相较于SC具有更好的肝内肿瘤控制。同时，单发肿瘤患者更有可能从HAIC中获益。版权所有 © 2023 Yang，Fu，Wu，Hu，Pan，Wang，Chen，Hu，Zhou，Chen和Zhang。

Background: Systemic chemotherapy (SC) remains the only first-line treatment for unresectable intrahepatic cholangiocarcinoma (iCCA). Hepatic arterial infusion chemotherapy (HAIC) has been recently proven to be effective in managing hepatocellular carcinoma (HCC). Hence, our study aims to investigate the safety and efficacy of HAIC in treating unresectable iCCA patients. Methods: We reviewed 146 patients with unresectable iCCA who had received HAIC or SC between March 2016 and March 2022 in a retrospective manner. Outcomes of patients and safety were compared between the HAIC and SC groups. Results: There were 75 and 71 patients in the HAIC and SC groups, respectively. The median OS in the HAIC and SC groups was 18.0 and 17.8 months (p = 0.84), respectively. The median PFS in the HAIC and SC groups was 10.8 and 11.4 months (p = 0.59), respectively. However, the HAIC group had significantly longer intrahepatic progression-free survival (IPFS) than the SC group (p = 0.035). The median IPFS in the HAIC and SC groups was 13.7 and 11.4 months, respectively. According to the OS (p = 0.047) and PFS (p = 0.009), single-tumor patients in the HAIC group appeared to benefit more. In addition, the overall incidence of adverse events (AEs) was lower in the HAIC group than that in the SC group. Conclusion: Our study revealed that HAIC was a safe and effective therapeutic regimen for unresectable iCCA with better intrahepatic tumor control when compared to SC. Meanwhile, patients with single tumor were more likely to benefit from HAIC than SC.Copyright © 2023 Yang, Fu, Wu, Hu, Pan, Wang, Chen, Hu, Zhou, Chen and Zhang.