Radiat Oncol J.  2014 Sep;32(3):163-169. 10.3857/roj.2014.32.3.163.

Outcomes of stereotactic body radiotherapy for unresectable primary or recurrent cholangiocarcinoma

• Jung DH
• Kim MS
• Cho CK
• Yoo HJ
• Jang WI
• Seo YS
• Paik EK
• Kim KB
• Han CJ
• Kim SB

• KMID: 2316731
• DOI: http://doi.org/10.3857/roj.2014.32.3.163

Abstract

PURPOSE
To report the results of stereotactic body radiotherapy (SBRT) for unresectable primary or recurrent cholangiocarcinoma.
MATERIALS AND METHODS
From January 2005 through August 2013, 58 patients with unresectable primary (n = 28) or recurrent (n = 30) cholangiocarcinoma treated by SBRT were retrospectively analyzed. The median prescribed dose was 45 Gy in 3 fractions (range, 15 to 60 Gy in 1-5 fractions). Patients were treated by SBRT only (n = 53) or EBRT + SBRT boost (n = 5). The median tumor volume was 40 mL (range, 5 to 1,287 mL).
RESULTS
The median follow-up duration was 10 months (range, 1 to 97 months). The 1-year, 2-year overall survival rates, and median survival were 45%, 20%, and 10 months, respectively. The median survival for primary group and recurrent group were 5 and 13 months, respectively. Local control rate at 1-year and 2-year were 85% and 72%, respectively. Disease progression-free survival rates at 1-year and 2-year were 26% and 23%, respectively. In univariate analysis, ECOG performance score (0-1 vs. 2-3), treatment volume (<50 vs. > or =50 mL), and pre-SBRT CEA level (<5 vs. > or =5 ng/mL) were significant in overall survival rate. In multivariate analysis, ECOG score (p = 0.037) and tumor volume (p = 0.030) were statistically significant. In the recurrent tumor group, patients with >12 months interval from surgery to recurrence showed statistically significant higher overall survival rate than those with < or =12 months (p = 0.026). Six patients (10%) experienced > or =grade 3 complications.
CONCLUSION
SBRT can be considered as an effective local modality for unresectable primary or recurrent cholangiocarcinoma.

Keyword

Radiosurgery; Cholangiocarcinoma

MeSH Terms

Cholangiocarcinoma*
Disease-Free Survival
Follow-Up Studies
Humans
Multivariate Analysis
Radiosurgery*
Recurrence
Retrospective Studies
Survival Rate
Tumor Burden