Stereotactic body radiotherapy (SBRT) for locally advanced extrahepatic and intrahepatic cholangiocarcinoma
- PMID: 28740893
- PMCID: PMC5514222
- DOI: 10.1016/j.adro.2016.10.008
Stereotactic body radiotherapy (SBRT) for locally advanced extrahepatic and intrahepatic cholangiocarcinoma
Abstract
Objectives: We report single-institution clinical efficacy and safety outcomes for patients with unresectable locally advanced cholangiocarcinoma who were treated with stereotactic body radiation therapy (SBRT) and a subset of patients who received neoadjuvant SBRT and chemotherapy as part of an orthotopic liver transplantation (OLT) protocol.
Methods and materials: From October 2008 to June 2015, 31 consecutive patients with unresectable extrahepatic (n = 25) or intrahepatic (n = 6) cholangiocarcinoma were treated with SBRT and retrospectively analyzed. Four patients underwent liver transplantation, and 1 underwent resection. SBRT was delivered in 5 fractions with a median dose of 40 Gy. Toxicity was scored using the Common Terminology Criteria for Adverse Events Version 4.0. Overall survival (OS), time to progression, and local control were estimated using the Kaplan-Meier method.
Results: The median follow-up time was 11.5 months. The 1- and 2-year OS rates were 59% and 33%, respectively, with a median survival of 15.7 months. The 1- and 2-year freedom from progression was 67% and 34%, respectively. Median time to progression was 16.8 months. Nine patients had local failure. The actuarial 1- and 2-year local control rates were 78% and 47%, respectively. Among patients who also had OLT, the median OS was 31.3 months. Twenty-four patients (77%) experienced some form of acute grade 1-2 toxicity, most commonly fatigue or pain. Five patients (16%) experienced grade ≥3 toxicity.
Conclusions: SBRT is a promising option for patients with unresectable or recurrent cholangiocarcinoma either as a component of neoadjuvant therapy prior to OLT or as part of definitive therapy for patients who are unresectable and not eligible for transplantation.
Figures
Similar articles
-
Stereotactic body radiotherapy (SBRT) for locally advanced intrahepatic and extrahepatic cholangiocarcinoma.BMC Cancer. 2017 Nov 21;17(1):781. doi: 10.1186/s12885-017-3788-1. BMC Cancer. 2017. PMID: 29162055 Free PMC article.
-
Clinical outcomes and toxicity using stereotactic body radiotherapy (SBRT) for advanced cholangiocarcinoma.Radiat Oncol. 2012 May 3;7:67. doi: 10.1186/1748-717X-7-67. Radiat Oncol. 2012. PMID: 22553982 Free PMC article.
-
Re-irradiation with stereotactic body radiation therapy as a novel treatment option for isolated local recurrence of pancreatic cancer after multimodality therapy: experience from two institutions.J Gastrointest Oncol. 2013 Dec;4(4):343-51. doi: 10.3978/j.issn.2078-6891.2013.044. J Gastrointest Oncol. 2013. PMID: 24294505 Free PMC article.
-
Actual over 3-year survival after stereotactic body radiation therapy in patients with unresectable intrahepatic cholangiocarcinoma.Clin Transl Oncol. 2023 Mar;25(3):731-738. doi: 10.1007/s12094-022-02979-5. Epub 2022 Nov 19. Clin Transl Oncol. 2023. PMID: 36401766 Review.
-
Normo- or Hypo-Fractionated Photon or Proton Radiotherapy in the Management of Locally Advanced Unresectable Pancreatic Cancer: A Systematic Review.Cancers (Basel). 2023 Jul 25;15(15):3771. doi: 10.3390/cancers15153771. Cancers (Basel). 2023. PMID: 37568587 Free PMC article. Review.
Cited by
-
Survival and Toxicity in Patients With Unresectable or Inoperable Biliary Tract Cancers With Ablative Radiation Therapy Versus Nonablative Chemoradiation.Adv Radiat Oncol. 2023 Dec 2;9(4):101412. doi: 10.1016/j.adro.2023.101412. eCollection 2024 Apr. Adv Radiat Oncol. 2023. PMID: 38778829 Free PMC article.
-
Proton beam therapy for extrahepatic biliary tract cancer: Analysis with prospective multi-institutional patients' registration database, Proton-Net.Clin Transl Radiat Oncol. 2023 May 3;41:100634. doi: 10.1016/j.ctro.2023.100634. eCollection 2023 Jul. Clin Transl Radiat Oncol. 2023. PMID: 37234735 Free PMC article.
-
Locoregional Therapy for Intrahepatic Cholangiocarcinoma.Cancers (Basel). 2023 Apr 20;15(8):2384. doi: 10.3390/cancers15082384. Cancers (Basel). 2023. PMID: 37190311 Free PMC article. Review.
-
Inter- and intrafraction dose variations in robotic stereotactic body radiation therapy (SBRT) for perihilar cholangiocarcinoma in the prospective phase I STRONG trial.Front Oncol. 2023 Mar 8;13:1114737. doi: 10.3389/fonc.2023.1114737. eCollection 2023. Front Oncol. 2023. PMID: 36969072 Free PMC article.
-
Ablative Therapy in Non-HCC Liver Malignancy.Cancers (Basel). 2023 Feb 14;15(4):1200. doi: 10.3390/cancers15041200. Cancers (Basel). 2023. PMID: 36831543 Free PMC article. Review.
References
-
- Welzel T.M., McGlynn K.A., Hsing A.W., O'Brien T.R., Pfieffer R.M. Impact of classification of hilar cholangiocarcinomas (Klatskin tumors) on the incidence of intra- and extrahepatic cholangiocarcinoma in the United States. J Natl Cancer Inst. 2006;98:873–875. - PubMed
-
- Vauthey J.N., Blumgart L.H. Recent advances in the management of cholangiocarcinomas. Semin Liver Dis. 1994;14:109–114. - PubMed
-
- Farley D.R., Weaver A.L., Nagorney D.M. “Natural history” of unresected cholangiocarcinoma: patient outcome after noncurative intervention. Mayo Clin Proc. 1995;70:425–429. - PubMed
-
- Grove M.K., Hermann R.E., Vogt D.P., Broughan T.A. Role of radiation after operative palliation in cancer of the proximal bile ducts. Am J Surg. 1991;161:454–458. - PubMed
LinkOut - more resources
Full Text Sources
Other Literature Sources