Hae Jin Park1, Kyubo Kim2, Eui Kyu Chie3, Jin-Young Jang4, Sun Whe Kim4, Sae-Won Han5, Do-Youn Oh5, Seock-Ah Im5, Tae-You Kim5, Yung-Jue Bang5, Sung W Ha3. 1. Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea. 2. Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea kyubokim@snu.ac.kr. 3. Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea. 4. Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea. 5. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Abstract
BACKGROUND: The purpose of the present study was to analyze the outcome of chemoradiotherapy for extrahepatic bile duct (EHBD) cancer patients with gross residual disease after surgical resection. PATIENTS AND METHODS: We retrospectively analyzed 30 patients with EHBD adenocarcinoma who underwent chemoradiotherapy after palliative resection (R2 resection). Postoperative radiotherapy was delivered to the tumor bed including residual tumor and regional lymph nodes (range=40-55.8 Gy). Most patients underwent chemoradiotherapy concurrently with 5-fluorouracil (5-FU) or gemcitabine. RESULTS: The 2-year locoregional progression-free, distant metastasis-free and overall survival rates were 33.3%, 42.4% and 44.5%, respectively. High radiation dose≥50 Gy had a marginally significant impact on superior locoregional progression-free survival compared to 40 Gy (p=0.081). One patient developed grade 3 late gastrointestinal toxicity. CONCLUSION: Adjuvant chemoradiotherapy for EHBD cancer patients with gross residual disease after surgery was well-tolerated. There could be a chance for durable locoregional control and even long-term survival in selected patients. Copyright
BACKGROUND: The purpose of the present study was to analyze the outcome of chemoradiotherapy for extrahepatic bile duct (EHBD) cancerpatients with gross residual disease after surgical resection. PATIENTS AND METHODS: We retrospectively analyzed 30 patients with EHBD adenocarcinoma who underwent chemoradiotherapy after palliative resection (R2 resection). Postoperative radiotherapy was delivered to the tumor bed including residual tumor and regional lymph nodes (range=40-55.8 Gy). Most patients underwent chemoradiotherapy concurrently with 5-fluorouracil (5-FU) or gemcitabine. RESULTS: The 2-year locoregional progression-free, distant metastasis-free and overall survival rates were 33.3%, 42.4% and 44.5%, respectively. High radiation dose≥50 Gy had a marginally significant impact on superior locoregional progression-free survival compared to 40 Gy (p=0.081). One patient developed grade 3 late gastrointestinal toxicity. CONCLUSION: Adjuvant chemoradiotherapy for EHBD cancerpatients with gross residual disease after surgery was well-tolerated. There could be a chance for durable locoregional control and even long-term survival in selected patients. Copyright