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Clinical outcomes of salvage chemoradiotherapy for locally recurrent biliary tract cancer

Abstract

Purpose

The purpose of this study was to investigate the clinical outcomes and prognostic factors of concurrent chemoradiotherapy (CCRT) for locally recurrent biliary tract cancer (BTC) after curative surgical resection.

Methods

We performed a retrospective cohort study of patients with locally recurrent BTC treated with CCRT between October 2004 and December 2013. The study included and analyzed 42 patients with a history of curative-intent surgical resection of confirmed adenocarcinoma originating from the biliary tract.

Results

The median time to recurrence after surgery was 16.1 months (range, 4.5-77.8 months). Median follow-up after CCRT was 26.9 months (range, 5.2-81.9) with no grade 3 or higher gastrointestinal toxicities. Analysis of the first site of failure showed local progression (LP) developed in 20 patients (47.6%); among these, 16 (38.1%) had isolated LP. The median values were 15.8 months (range, 1.7-81.7) for LP-free survival (LPFS), 10.6 months (range, 1.7 - 81.7) for progression-free survival (PFS) and 41.2 months (range, 5.2-81.9) for overall survival (OS). Multivariate analysis showed that the level of pre-CCRT carbohydrate antigen (CA) 19-9 and the chemotherapy regimen were significant prognostic factors for LPFS and PFS; pT stage was the only significant prognostic factor for OS.

Conclusions

CCRT for locally recurrent BTC showed promising outcomes as a salvage modality, but LP was still frequent. The pre-CCRT CA 19-9 level and the chemotherapy regimen were prognostic factors for LPFS and PFS.

Tumori 2017; 103(4): 345 - 352

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/tj.5000666

Authors

Jeong Il Yu, Hee Chul Park, Do Hoon Lim, Joon Oh Park, Young Suk Park, Seung Tae Kim, Seong Ho Choi, Dong Wook Choi, In Woong Han, Jin Seok Heo

Article History

Disclosures

Financial support: The research was supported by a Samsung Medical Center grant (GF01130081), a Basic Science Research Program through the National Research Foundation of Korea (NRF-2015R1D1A1A01060945) funded by the Ministry of Education, and a grant from the Marine Biotechnology Program (20150220) funded by the Ministry of Oceans and Fisheries of Korea.
Conflict of interest: The authors declare that they have no conflicts of interest related to this work.

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Authors

Affiliations

  • Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul - Korea
  • Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul - Korea
  • Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul - Korea
  • Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, Seoul - Korea

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