BACKGROUND: We present results of patients diagnosed with unresectable hilar cholangiocarcinomas treated with high dose radiotherapy and concurrent chemotherapy. METHODS: From Aug 2005 to Dec 2012, 68 consecutive patients were treated. Fifty patients (group 1) presenting to us with obstructive jaundice were planned for endobiliary brachytherapy (EBBT 14 Gy) followed external beam radiotherapy (EBRT 45 Gy). Twenty-two patients (group 2) who had previously undergone biliary drainage underwent EBRT (57 Gy). All patients received injection Gemcitabine 300 mg/m2/weekly along with EBRT. RESULTS: Twenty-nine patients in group 1 and 22 patients in group 2 completed the treatment. Twenty-six (55%) patients achieved complete radiological response, 16 (64%) belonging to group 1 and 8 (44%) of group 2 (P=0.05). The median overall survival (MOS) was 17.5 and 16 months for group 1 and 2 respectively (P=0.07). The 1- and 2-year survival was 63%, and 18% for group I and 61% and 22% for group II respectively. The MOS was 5 months and 1 year survival was 14% for patients receiving EBBT only. MOS was significantly better after complete response (P=0.001). CONCLUSIONS: Intensity modulated radiotherapy (IMRT) modulated high dose radiotherapy used either alone or with brachytherapy demonstrates potential to prolonged overall survival in unresectable hilar cholangiocarcinomas.
BACKGROUND: We present results of patients diagnosed with unresectable hilar cholangiocarcinomas treated with high dose radiotherapy and concurrent chemotherapy. METHODS: From Aug 2005 to Dec 2012, 68 consecutive patients were treated. Fifty patients (group 1) presenting to us with obstructive jaundice were planned for endobiliary brachytherapy (EBBT 14 Gy) followed external beam radiotherapy (EBRT 45 Gy). Twenty-two patients (group 2) who had previously undergone biliary drainage underwent EBRT (57 Gy). All patients received injection Gemcitabine 300 mg/m2/weekly along with EBRT. RESULTS: Twenty-nine patients in group 1 and 22 patients in group 2 completed the treatment. Twenty-six (55%) patients achieved complete radiological response, 16 (64%) belonging to group 1 and 8 (44%) of group 2 (P=0.05). The median overall survival (MOS) was 17.5 and 16 months for group 1 and 2 respectively (P=0.07). The 1- and 2-year survival was 63%, and 18% for group I and 61% and 22% for group II respectively. The MOS was 5 months and 1 year survival was 14% for patients receiving EBBT only. MOS was significantly better after complete response (P=0.001). CONCLUSIONS: Intensity modulated radiotherapy (IMRT) modulated high dose radiotherapy used either alone or with brachytherapy demonstrates potential to prolonged overall survival in unresectable hilar cholangiocarcinomas.
Authors: Hyun Soo Shin; Jinsil Seong; Woo Chul Kim; Hyung Sik Lee; Sun Rock Moon; Ik Jae Lee; Kang Kyu Lee; Kyung Ran Park; Chang Ok Suh; Gwi Eon Kim Journal: Int J Radiat Oncol Biol Phys Date: 2003-09-01 Impact factor: 7.038
Authors: A G Morganti; L Trodella; V Valentini; P Montemaggi; G Costamagna; D Smaniotto; S Luzi; P Ziccarelli; G Macchia; V Perri; M Mutignani; N Cellini Journal: Int J Radiat Oncol Biol Phys Date: 2000-03-01 Impact factor: 7.038
Authors: Juan Valle; Harpreet Wasan; Daniel H Palmer; David Cunningham; Alan Anthoney; Anthony Maraveyas; Srinivasan Madhusudan; Tim Iveson; Sharon Hughes; Stephen P Pereira; Michael Roughton; John Bridgewater Journal: N Engl J Med Date: 2010-04-08 Impact factor: 91.245
Authors: A Paiman Ghafoori; John W Nelson; Christopher G Willett; Junzo Chino; Douglas S Tyler; Herbert I Hurwitz; Hope E Uronis; Michael A Morse; Robert W Clough; Brian G Czito Journal: Int J Radiat Oncol Biol Phys Date: 2010-09-23 Impact factor: 7.038
Authors: Christopher H Crane; Kenneth O Macdonald; J N Vauthey; Patt Yehuda; Thomas Brown; Steven Curley; Adrian Wong; Marc Delclos; Chusilp Charnsangavej; Nora A Janjan Journal: Int J Radiat Oncol Biol Phys Date: 2002-07-15 Impact factor: 7.038