Intensity-modulated radiotherapy following null-margin resection is associated with improved survival in the treatment of intrahepatic cholangiocarcinoma
Background: The current study is the first to examine the effectiveness and toxicity of postoperative intensity-modulated radiotherapy (IMRT) in the treatment of intrahepatic cholangiocarcinoma (ICC) abutting the vasculature.Specifically, we aim to assess the role of IMRT in patients with ICC undergoing null-margin (no real resection margin) resection.Methods: Thirty-eight patients with ICC adherent to major blood vessels were included in this retrospective study.Null-margin resection was performed on all patients;14 patients were further treated with IMRT.The median radiation dose delivered was 56.8 Gy (range, 50-60 Gy).The primary endpoints were overall survival (OS) and disease-free survival (DFS).Results: At a median follow-up of 24.6 months, the median OS and DFS of all patients (n=38) were 17.7 months (95% CI, 13.2-22.2) and 9.9 months (95% CI, 2.8-17.0), respectively.Median OS was 21.8 months (95% CI, 15.5-28.1) among the 14 patients in the postoperative IMRT group and 15.0 months (95% CI, 9.2-20.9) among the 24 patients in the surgery-only group (P=0.049).Median DFS was 12.5 months (95% CI, 6.8-18.2) in the postoperative IMRT group and 5.5 months (95% CI, 0.7-12.3) in the surgery-only group (P=0.081).IMRT was well-tolerated.Acute toxicity included one case of Grade 3 leukopenia;late toxicity included one case of asymptomatic duodenal ulcer discovered through endoscopy.Conclusions: The study results suggest that postoperative IMRT is a safe and effective treatment option following null-margin resections of ICC.Larger prospective and randomized trials are necessary to establish postoperative IMRT as a standard practice for the treatment of ICC adherent to major hepatic vessels.
Radiotherapy intensity-modulated intrahepatic cholangiocarcinoma (ICC) null-margin resection postoperative radiotherapy
Angela Y.Jia Jian-Xiong Wu Yu-Ting Zhao Ye-Xiong Li Zhi Wang Wei-Qi Rong Li-Ming Wang Jing Jin Shu-Lian Wang Yong-Wen Song Yue-Ping Liu Hua Ren Hui Fang Wen-Qing Wang Xin-Fan Liu Zi-Hao Yu Wei-Hu Wang
Department of Medicine,Weill Cornell Medical College,New York City,NY,USA Department of Abdominal Surgery,Cancer Hospital and Institute,Chinese Academy of Medical Sciences (C Department of Radiation Oncology,Cancer Hospital and Institute,Chinese Academy of Medical Sciences (
国内会议
北京
英文
502-509
2016-01-09（万方平台首次上网日期，不代表论文的发表时间）