International journal of radiation oncology, biology, physics 2009-01-01
Concurrent chemoradiotherapy in resected extrahepatic cholangiocarcinoma.
ABSTRACT
PURPOSE
Extrahepatic cholangiocarcinoma is a rare malignancy. Despite radical resection, survival remains poor, with high rates of local and distant failure. To clarify the role of radiotherapy with chemotherapy, we performed a retrospective analysis of resected patients who had undergone chemoradiotherapy.
METHODS AND MATERIALS
A total of 45 patients (13 with proximal and 32 with distal disease) underwent resection plus radiotherapy (median dose, 50.4 Gy). All but 1 patient received concurrent fluoropyrimidine-based chemotherapy. The median follow-up was 30 months for all patients and 40 months for survivors.
RESULTS
Of the 45 patients, 33 underwent adjuvant radiotherapy, and 12 were treated neoadjuvantly. The 5-year actuarial overall survival, disease-free survival, metastasis-free survival, and locoregional control rates were 33%, 37%, 42%, and 78%, respectively. The median survival was 34 months. No patient died perioperatively. Patient age
CONCLUSION
These study results suggest a possible local control benefit from chemoradiotherapy combined with surgery in patients with advanced, resected biliary cancer. Furthermore, our results suggest that a treatment strategy that includes preoperative chemoradiotherapy might result in improved tumor resectability with similar surgical morbidity compared with patients treated postoperatively, as well as potentially improved survival outcomes. Distant failure remains a significant failure pattern, suggesting the need for more effective systemic therapy.
Related Questions
Would you offer chemotherapy alone per data from BILCAP or is there any role of radiation?
New answer by Medical Oncologist at University of Utah Huntsman Cancer Institute (November 17, 2018)
We would offer adjuvant chemotherapy to this patient based on data from the BILCAP study. Final results are still to be published in a peer reviewed journal. This study enroll...