Eunji Kim1, Yi-Jun Kim2, Kyubo Kim2, Changhoon Song3, Jae-Sung Kim3, Do-Youn Oh4, Eun Mi Nam5, Eui Kyu Chie1. 1. 1 Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea. 2. 2 Department of Radiation Oncology, Ewha Womans University College of Medicine, Seoul, Republic of Korea. 3. 3 Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Republic of Korea. 4. 4 Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. 5. 5 Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea.
Abstract
OBJECTIVE: This study evaluated the outcome of salvage radiotherapy for locoregionally recurrent extrahepatic bile duct cancer. METHODS: We performed a retrospective review of 23 extrahepatic bile duct cancer patients who underwent radiotherapy with or without concomitant chemotherapy for isolated locoregional recurrence after radical surgery between August 2001 and September 2013. The median disease-free interval was 11.8 months. Salvage radiotherapy was delivered to the recurrent tumour with or without initial operation bed up to a median dose of 54 Gy (range, 45-60). 18 patients received concomitant chemotherapy. RESULTS: The median follow-up period was 14.2 months for all patients, and 48.8 months for survivors. The median overall survival and progression-free survival (PFS) were 18.4 (range, 4.4-114.6) and 15.5 months (range, 1.6-114.6), respectively. On multivariate analysis, the use of concomitant chemotherapy was a favourable prognostic factor for PFS (p = 0.027), and prolonged disease-free interval (≥1 year) was associated with a significantly poor overall survival (p = 0.047). Grade 3 or higher toxicities did not occur in follow-up period. CONCLUSION: Salvage radiotherapy showed promising survival outcomes in locoregional recurrence of extrahepatic bile duct cancer. Our results indicated that concomitant chemotherapy was associated with improved PFS. Concurrent chemoradiotherapy can be a viable salvage treatment option in selected patients. Advances in knowledge: Locoregional recurrence is the most common pattern of failure after radical resection in extrahepatic bile duct cancer. In this study, salvage radiotherapy showed favourable survival outcomes without severe complications in locoregionally recurrent extrahepatic bile duct cancer patients.
OBJECTIVE: This study evaluated the outcome of salvage radiotherapy for locoregionally recurrent extrahepatic bile duct cancer. METHODS: We performed a retrospective review of 23 extrahepatic bile duct cancerpatients who underwent radiotherapy with or without concomitant chemotherapy for isolated locoregional recurrence after radical surgery between August 2001 and September 2013. The median disease-free interval was 11.8 months. Salvage radiotherapy was delivered to the recurrent tumour with or without initial operation bed up to a median dose of 54 Gy (range, 45-60). 18 patients received concomitant chemotherapy. RESULTS: The median follow-up period was 14.2 months for all patients, and 48.8 months for survivors. The median overall survival and progression-free survival (PFS) were 18.4 (range, 4.4-114.6) and 15.5 months (range, 1.6-114.6), respectively. On multivariate analysis, the use of concomitant chemotherapy was a favourable prognostic factor for PFS (p = 0.027), and prolonged disease-free interval (≥1 year) was associated with a significantly poor overall survival (p = 0.047). Grade 3 or higher toxicities did not occur in follow-up period. CONCLUSION: Salvage radiotherapy showed promising survival outcomes in locoregional recurrence of extrahepatic bile duct cancer. Our results indicated that concomitant chemotherapy was associated with improved PFS. Concurrent chemoradiotherapy can be a viable salvage treatment option in selected patients. Advances in knowledge: Locoregional recurrence is the most common pattern of failure after radical resection in extrahepatic bile duct cancer. In this study, salvage radiotherapy showed favourable survival outcomes without severe complications in locoregionally recurrent extrahepatic bile duct cancerpatients.
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