Outcomes of Concurrent Chemoradiotherapy Versus Chemotherapy Alone for Advanced-stage Unresectable Intrahepatic Cholangiocarcinoma

Overview

Journal Radiat Oncol

Publisher Biomed Central

Specialties Oncology
Radiology

Date 2013 Dec 24

PMID 24359879

Citations 33

Authors

Young-Il Kim

Joong-Won Park

Bo Hyun Kim

Sang Myung Woo

Tae Hyun Kim

Young Hwan Koh

Woo Jin Lee

Chang-Min Kim

Affiliations

Soon will be listed here.

Abstract

Background: A standard treatment for unresectable advanced-stage intrahepatic cholangiocarcinoma (IHCC) has not yet been established. Although neoadjuvant concurrent chemoradiotherapy (CCRT) and liver transplantation are associated with long-term survival in select patients, the outcomes of CCRT for advanced-stage unresectable IHCC remain unclear. The aim of our study was to evaluate the outcomes of CCRT in patients with unresectable advanced-stage IHCC.

Methods: We retrospectively reviewed the records of all patients with unresectable advanced stage (stage IVa or IVb) IHCC who were pathologically diagnosed and treated at National Cancer Center, Korea, from June 2001 to March 2012. Of the total of 92 patients, 25 (27.1%) received capecitabine plus cisplatin (XP) chemotherapy with external radiotherapy (RT) (XP-CCRT group) and 67 (72.8%) received XP chemotherapy alone (XP group). The clinical characteristics and outcomes of the 2 groups were compared.

Results: The 92 patients comprised 72 male and 20 female patients, with a median age of 58 years (range 26-78 years). The baseline clinical characteristics of the 2 groups were similar. Patients in the XP-CCRT group received a mean 44.7 Gy of RT and a mean 5.6 cycles of XP chemotherapy, whereas patients in the XP group received a mean 4.0 cycles. The disease control rate was higher in the XP-CCRT group than in the XP group, but the difference was not statistically significant (56.0% vs. 41.5%, p = 0.217). Although neutropenia was significantly more frequent in the XP-CCRT than in the XP group (48% vs. 9%, p < 0.001), the rates of other toxicities and > grade 3 toxicities did not differ. At a median follow-up of 5.3 months, PFS (4.3 vs. 1.9 months, p = 0.001) and OS (9.3 vs. 6.2 months, p = 0.048) were significantly longer in the XP-CCRT than in the XP group.

Conclusions: XP-CCRT was well tolerated and was associated with longer PFS and OS than XP chemotherapy alone in patients with unresectable advanced IHCC. Controlled randomized trials are required to determine whether XP-CCRT is a primary treatment option for patients with unresectable advanced IHCC.

Citing Articles

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SBRT for Liver Tumors: What the Interventional Radiologist Needs to Know.

Gutman M, Serra L, Koshy M, Katipally R Semin Intervent Radiol. 2024; 41(1):1-10.

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Combined High-Dose Radiotherapy with Sequential Gemcitabine-Cisplatin Based Chemotherapy Increase the Resectability and Survival in Locally Advanced Unresectable Intrahepatic Cholangiocarcinoma: A Multi-institutional Cohort Study.

Im J, Yu J, Kim T, Kim T, Kim J, Seong J Cancer Res Treat. 2024; 56(3):838-846.

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Locoregional therapy combined with systemic therapy (LRT + ST) for unresectable and metastatic intrahepatic cholangiocarcinoma: a systematic review and meta-analysis.

Zhang M, Qi W, Qiu X, Yu C, Qiu W, Wang S Radiol Oncol. 2023; 57(4):419-429.

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Locoregional Treatment in Intrahepatic Cholangiocarcinoma: Which Treatment for Which Patient?.

Bourien H, Pircher C, Guiu B, Lamarca A, Valle J, Niger M Cancers (Basel). 2023; 15(17).

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