Verbesserte onkologische Ergebnisse mit Chemoradiotherapie gefolgt von einer Operation beim nichtresezierbaren intrahepatischen Cholangiokarzinom

Translated title of the contribution: Improved oncologic outcome with chemoradiotherapy followed by surgery in unresectable intrahepatic cholangiocarcinoma

Yeona Cho, Tae Hyung Kim, Jinsil Seong

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: To investigate the ability of chemoradiotherapy (CRT) to down-stage unresectable intrahepatic cholangiocarcinoma (IHCC) to resectable lesions, as well as the factors associated with achieving such down-staging. Methods: The study cohort comprised 120 patients diagnosed with stage I–IVA IHCC between 2001 and 2012. Of these patients, 56 underwent surgery and 64 received CRT as their initial treatment. The rate of curative resections for patients who received CRT was assessed, and the locoregional failure-free survival (LRFFS) and overall survival (OS) rates of these patients were compared to those of patients who underwent CRT alone. Results: Median follow-up was 36 months. A partial response after CRT was observed in 25% of patients, whereas a biologic response (a >70% decrease of CA19-9) was observed in 35%. Eight patients (12.5%) received curative resection after CRT and showed significantly improved LRFFS and OS compared to those treated with CRT alone (3-year LRFFS: 50 vs. 15.7%, respectively, p = 0.03; 3‑year OS: 50 vs. 11.2%, respectively, p = 0.012); these rates were comparable to those of patients who received initial surgery. Factors associated with curative surgery after CRT were gemcitabine administration, higher radiotherapy dose (biological effective dose ≥55 Gy with α/β = 10), and a >70% reduction of CA19-9. Conclusion: Upfront CRT could produce favorable outcomes by converting unresectable lesions to resectable tumors in selected patients. Higher radiotherapy doses and gemcitabine-based chemotherapy yielded a significant reduction of CA19-9 after CRT; patients with these characteristics had a greater chance of curative resection and improved OS.

Original languageGerman
Pages (from-to)620-629
Number of pages10
JournalStrahlentherapie und Onkologie
Volume193
Issue number8
DOIs
Publication statusPublished - 2017 Aug 1

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Cholangiocarcinoma
Chemoradiotherapy
gemcitabine
Survival
Radiotherapy
Cohort Studies
Survival Rate
Drug Therapy

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Oncology

Cite this

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title = "Verbesserte onkologische Ergebnisse mit Chemoradiotherapie gefolgt von einer Operation beim nichtresezierbaren intrahepatischen Cholangiokarzinom",
abstract = "Purpose: To investigate the ability of chemoradiotherapy (CRT) to down-stage unresectable intrahepatic cholangiocarcinoma (IHCC) to resectable lesions, as well as the factors associated with achieving such down-staging. Methods: The study cohort comprised 120 patients diagnosed with stage I–IVA IHCC between 2001 and 2012. Of these patients, 56 underwent surgery and 64 received CRT as their initial treatment. The rate of curative resections for patients who received CRT was assessed, and the locoregional failure-free survival (LRFFS) and overall survival (OS) rates of these patients were compared to those of patients who underwent CRT alone. Results: Median follow-up was 36 months. A partial response after CRT was observed in 25{\%} of patients, whereas a biologic response (a >70{\%} decrease of CA19-9) was observed in 35{\%}. Eight patients (12.5{\%}) received curative resection after CRT and showed significantly improved LRFFS and OS compared to those treated with CRT alone (3-year LRFFS: 50 vs. 15.7{\%}, respectively, p = 0.03; 3‑year OS: 50 vs. 11.2{\%}, respectively, p = 0.012); these rates were comparable to those of patients who received initial surgery. Factors associated with curative surgery after CRT were gemcitabine administration, higher radiotherapy dose (biological effective dose ≥55 Gy with α/β = 10), and a >70{\%} reduction of CA19-9. Conclusion: Upfront CRT could produce favorable outcomes by converting unresectable lesions to resectable tumors in selected patients. Higher radiotherapy doses and gemcitabine-based chemotherapy yielded a significant reduction of CA19-9 after CRT; patients with these characteristics had a greater chance of curative resection and improved OS.",
author = "Yeona Cho and Kim, {Tae Hyung} and Jinsil Seong",
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Verbesserte onkologische Ergebnisse mit Chemoradiotherapie gefolgt von einer Operation beim nichtresezierbaren intrahepatischen Cholangiokarzinom. / Cho, Yeona; Kim, Tae Hyung; Seong, Jinsil.

In: Strahlentherapie und Onkologie, Vol. 193, No. 8, 01.08.2017, p. 620-629.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Verbesserte onkologische Ergebnisse mit Chemoradiotherapie gefolgt von einer Operation beim nichtresezierbaren intrahepatischen Cholangiokarzinom

AU - Cho, Yeona

AU - Kim, Tae Hyung

AU - Seong, Jinsil

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N2 - Purpose: To investigate the ability of chemoradiotherapy (CRT) to down-stage unresectable intrahepatic cholangiocarcinoma (IHCC) to resectable lesions, as well as the factors associated with achieving such down-staging. Methods: The study cohort comprised 120 patients diagnosed with stage I–IVA IHCC between 2001 and 2012. Of these patients, 56 underwent surgery and 64 received CRT as their initial treatment. The rate of curative resections for patients who received CRT was assessed, and the locoregional failure-free survival (LRFFS) and overall survival (OS) rates of these patients were compared to those of patients who underwent CRT alone. Results: Median follow-up was 36 months. A partial response after CRT was observed in 25% of patients, whereas a biologic response (a >70% decrease of CA19-9) was observed in 35%. Eight patients (12.5%) received curative resection after CRT and showed significantly improved LRFFS and OS compared to those treated with CRT alone (3-year LRFFS: 50 vs. 15.7%, respectively, p = 0.03; 3‑year OS: 50 vs. 11.2%, respectively, p = 0.012); these rates were comparable to those of patients who received initial surgery. Factors associated with curative surgery after CRT were gemcitabine administration, higher radiotherapy dose (biological effective dose ≥55 Gy with α/β = 10), and a >70% reduction of CA19-9. Conclusion: Upfront CRT could produce favorable outcomes by converting unresectable lesions to resectable tumors in selected patients. Higher radiotherapy doses and gemcitabine-based chemotherapy yielded a significant reduction of CA19-9 after CRT; patients with these characteristics had a greater chance of curative resection and improved OS.

AB - Purpose: To investigate the ability of chemoradiotherapy (CRT) to down-stage unresectable intrahepatic cholangiocarcinoma (IHCC) to resectable lesions, as well as the factors associated with achieving such down-staging. Methods: The study cohort comprised 120 patients diagnosed with stage I–IVA IHCC between 2001 and 2012. Of these patients, 56 underwent surgery and 64 received CRT as their initial treatment. The rate of curative resections for patients who received CRT was assessed, and the locoregional failure-free survival (LRFFS) and overall survival (OS) rates of these patients were compared to those of patients who underwent CRT alone. Results: Median follow-up was 36 months. A partial response after CRT was observed in 25% of patients, whereas a biologic response (a >70% decrease of CA19-9) was observed in 35%. Eight patients (12.5%) received curative resection after CRT and showed significantly improved LRFFS and OS compared to those treated with CRT alone (3-year LRFFS: 50 vs. 15.7%, respectively, p = 0.03; 3‑year OS: 50 vs. 11.2%, respectively, p = 0.012); these rates were comparable to those of patients who received initial surgery. Factors associated with curative surgery after CRT were gemcitabine administration, higher radiotherapy dose (biological effective dose ≥55 Gy with α/β = 10), and a >70% reduction of CA19-9. Conclusion: Upfront CRT could produce favorable outcomes by converting unresectable lesions to resectable tumors in selected patients. Higher radiotherapy doses and gemcitabine-based chemotherapy yielded a significant reduction of CA19-9 after CRT; patients with these characteristics had a greater chance of curative resection and improved OS.

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