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Impact of radiotherapy in the management of locally advanced extrahepatic cholangiocarcinoma.

Moureau-Zabotto L, Turrini O, Resbeut M, Raoul JL, Giovannini M, Poizat F, Piana G, Delpero JR, Bertucci F - BMC Cancer (2013)

Bottom Line: Twenty-eight patients (93%) died of relapse or disease complications.Median overall survivals in the whole group and in group 1 or 2 were respectively 12, 11 and 21 months (p = 0.11).The 1-year and 3-year progression-free survivals were respectively 38% and 16% in the whole series; 31% and 11% in group 1, 67% and 33% in group 2 (p = 0.35).

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Radiation Therapy, Institut Paoli-Calmettes, 232 Boulevard de Sainte Marguerite, 13009 Marseille, France. moureaul@ipc.unicancer.fr.

ABSTRACT

Background: Optimal therapy for patients with unresectable locally advanced extrahepatic cholangiocarcinoma (ULAC) remains controversial. We analysed the role of radiotherapy in the management of such tumors.

Methods: We retrospectively reviewed the charts of patients treated in our institution with conformal-3D external-beam-radiotherapy (EBRT) with or without concurrent chemotherapy.

Results: Thirty patients were included: 24 with a primary tumor (group 1) and 6 with a local relapse (group 2). Toxicity was low. Among 25 patients assessable for EBRT response, we observed 9 complete responses, 4 partial responses, 10 stabilisations, and 2 progressions. The median follow-up was 12 months. Twenty out of 30 patients (66%) experienced a relapse, which was metastatic in 75% of cases in the whole series, 87% in group 1, 60% in group 2 (p = 0.25). Twenty-eight patients (93%) died of relapse or disease complications. Median overall survivals in the whole group and in group 1 or 2 were respectively 12, 11 and 21 months (p = 0.11). The 1-year and 3-year progression-free survivals were respectively 38% and 16% in the whole series; 31% and 11% in group 1, 67% and 33% in group 2 (p = 0.35).

Conclusion: EBRT seems efficient to treat ULAC, with acceptable toxicity. For primary disease, the high rate of metastatic relapse suggests to limit EBRT to non-progressive patients after induction chemotherapy.

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Overall survival for overall population (Fig 2a), and according to the group of patients (Fig 2b).
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Figure 2: Overall survival for overall population (Fig 2a), and according to the group of patients (Fig 2b).

Mentions: In the whole population, the median follow up was 12 months (range, 1–83). Twenty out of 30 patients (66%) experienced a disease progression that was metastatic (15 patients, 50%), local (4 patients, 13%), or both local and metastatic (1 patient, 3%). Within the 16 patients who presented distant metastasis, the metastatic site was peritoneum (n = 10), liver (n = 4), lung (n = 1), and both liver and bone (n = 1). The 1-year and 3-year PFS were 38.4 ± 9% and 15.7% ± 7% respectively (Figure 1a); the median PFS was 9 months (range, 1–11). Twenty-eight patients (93%) died: 20 died of disease recurrence (66%), 6 (17%) of complications (detailed below), and 2 of unknown cause. The 1-year and 3-year OS were 52% ± 9.3% and 15.3% ± 6.9% respectively (Figure 2a). The median OS was was 12 months (range, 1–15).


Impact of radiotherapy in the management of locally advanced extrahepatic cholangiocarcinoma.

Moureau-Zabotto L, Turrini O, Resbeut M, Raoul JL, Giovannini M, Poizat F, Piana G, Delpero JR, Bertucci F - BMC Cancer (2013)

Overall survival for overall population (Fig 2a), and according to the group of patients (Fig 2b).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4219485&req=5

Figure 2: Overall survival for overall population (Fig 2a), and according to the group of patients (Fig 2b).
Mentions: In the whole population, the median follow up was 12 months (range, 1–83). Twenty out of 30 patients (66%) experienced a disease progression that was metastatic (15 patients, 50%), local (4 patients, 13%), or both local and metastatic (1 patient, 3%). Within the 16 patients who presented distant metastasis, the metastatic site was peritoneum (n = 10), liver (n = 4), lung (n = 1), and both liver and bone (n = 1). The 1-year and 3-year PFS were 38.4 ± 9% and 15.7% ± 7% respectively (Figure 1a); the median PFS was 9 months (range, 1–11). Twenty-eight patients (93%) died: 20 died of disease recurrence (66%), 6 (17%) of complications (detailed below), and 2 of unknown cause. The 1-year and 3-year OS were 52% ± 9.3% and 15.3% ± 6.9% respectively (Figure 2a). The median OS was was 12 months (range, 1–15).

Bottom Line: Twenty-eight patients (93%) died of relapse or disease complications.Median overall survivals in the whole group and in group 1 or 2 were respectively 12, 11 and 21 months (p = 0.11).The 1-year and 3-year progression-free survivals were respectively 38% and 16% in the whole series; 31% and 11% in group 1, 67% and 33% in group 2 (p = 0.35).

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Radiation Therapy, Institut Paoli-Calmettes, 232 Boulevard de Sainte Marguerite, 13009 Marseille, France. moureaul@ipc.unicancer.fr.

ABSTRACT

Background: Optimal therapy for patients with unresectable locally advanced extrahepatic cholangiocarcinoma (ULAC) remains controversial. We analysed the role of radiotherapy in the management of such tumors.

Methods: We retrospectively reviewed the charts of patients treated in our institution with conformal-3D external-beam-radiotherapy (EBRT) with or without concurrent chemotherapy.

Results: Thirty patients were included: 24 with a primary tumor (group 1) and 6 with a local relapse (group 2). Toxicity was low. Among 25 patients assessable for EBRT response, we observed 9 complete responses, 4 partial responses, 10 stabilisations, and 2 progressions. The median follow-up was 12 months. Twenty out of 30 patients (66%) experienced a relapse, which was metastatic in 75% of cases in the whole series, 87% in group 1, 60% in group 2 (p = 0.25). Twenty-eight patients (93%) died of relapse or disease complications. Median overall survivals in the whole group and in group 1 or 2 were respectively 12, 11 and 21 months (p = 0.11). The 1-year and 3-year progression-free survivals were respectively 38% and 16% in the whole series; 31% and 11% in group 1, 67% and 33% in group 2 (p = 0.35).

Conclusion: EBRT seems efficient to treat ULAC, with acceptable toxicity. For primary disease, the high rate of metastatic relapse suggests to limit EBRT to non-progressive patients after induction chemotherapy.

Show MeSH
Related in: MedlinePlus