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Review
. 2024 May 4;16(9):1776.
doi: 10.3390/cancers16091776.

The Current Role of Radiation in the Management of Cholangiocarcinoma-A Narrative Review

Saurav Verma  1   2 , Natalie Grindrod  1   2 , Daniel Breadner  1   2 , Michael Lock  1   2
Affiliations
Review

The Current Role of Radiation in the Management of Cholangiocarcinoma-A Narrative Review

Saurav Verma et al. Cancers (Basel). .

Abstract

Cholangiocarcinoma (CCA) is a rare cancer of bile ducts. It is associated with a poor prognosis. The incidence of CCA is rising worldwide. Anatomical subgroups have been used to classify patients for treatment and prognosis. There is a growing understanding of clinically important distinctions based on underlying genetic differences that lead to different treatment options and outcomes. Its management is further complicated by a heterogeneous population and relative rarity, which limits the conduct of large trials to guide management. Surgery has been the primary method of therapy for localized disease; however, recurrence and death remain high with or without surgery. Therefore, there have been concerted efforts to investigate new treatment options, such as the use of neoadjuvant treatments to optimize surgical outcomes, targeted therapy, leveraging a new understanding of immunobiology and stereotactic radiation. In this narrative review, we address the evidence to improve suboptimal outcomes in unresectable CCA with radiation, as well as the role of radiation in neoadjuvant and postoperative treatment. We also briefly discuss the recent developments in systemic treatment with targeted therapies and immune checkpoint inhibitors.

Keywords: chemotherapy; cholangiocarcinoma; gallbladder; radiotherapy; surgery; systemic therapy; targeted treatment.

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Conflict of interest statement

DB has accepted honoraria and/or speaking fees from Astra Zeneca, Amgen, Bristol-Myers Squibb, Takeda, Bayer, Guardant, Roche, Janssen, and Merck. ML has accepted honoraria and/or consulting fees from Tersera, Ferring, Eisai, Tolmar, Abbvie, Bayer, and Knight Therapeutics. The rest of the authors have no conflicts of interest.

Figures

Figure 1
Figure 1
Anatomic subtypes of CCA with associated genetic aberrations (this schematic was created using Servier Medical Art templates, which are licensed under a Creative Commons Attribution 4.0 Unported License; https://smart.servier.com, accessed on 2 February 2024).
See this image and copyright information in PMC

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