Background: Cholangiocarcinoma (CCA) is a rare malignant tumor of the bile duct epithelium. At first diagnosis, only a minority of patients are eligible for surgery, which is regarded as the only curative treatment. This study examines the role of radiation therapy (RT) and chemoradiotherapy (CRT) in the definitive and adjuvant treatment situation. Methods: The monocentric, retrospective analysis included 39 patients with CCA undergoing 53 RT courses. Data were collected from January 2005 to September 2018. There were 11 cases of CRT, 6 of which were definitive. Surgery was either palliative (n = 6) or radical (n = 15). Results: After RT, the median overall survival (OS) was 10.4 months (m), median progression-free survival was 5.6 m, and median duration of local control (DOLC) was 8.9 m. There was a significant difference in survival between patients with and without locoregional lymph node metastasis (OS: 4.3 vs. 15.4 m, p = 0.031). After treatment of a primary tumor, DOLC was about twice as long as in the recurrent situation (10.4 vs. 5.4 m, p = 0.032). Conservative therapy significantly elevated the risk of local recurrence compared to radical surgery in univariate and multivariate analyses. Side effects were mostly classified as mild to moderate. Termination of RT and increased alanine aminotransferase were significantly less frequent after stereotactic body radiation therapy and hypofractionation. Conclusion: RT can achieve local control in patients with CCA. Toxicities of RT are manageable but require close clinical and laboratory follow-up.
Oncol Res Treat

中文翻译：

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检查放射治疗在胆管癌中的应用：现代技术带来的好处

背景：胆管癌（CCA）是一种罕见的胆管上皮恶性肿瘤。最初诊断时，只有少数患者符合手术条件，这被认为是唯一的治愈性治疗方法。本研究探讨了放射治疗 (RT) 和放化疗 (CRT) 在确定性和辅助治疗情况中的作用。方法：单中心、回顾性分析包括 39 名接受 53 次放疗的 CCA 患者。数据收集时间为 2005 年 1 月至 2018 年 9 月。共有 11 例 CRT，其中 6 例为确诊病例。手术要么是姑息性的（ n = 6）要么是根治性的（ n = 15）。结果：放疗后，中位总生存期 (OS) 为 10.4 个月 (m)，中位无进展生存期为 5.6 m，中位局部控制持续时间 (DOLC) 为 8.9 m。有和没有局部淋巴结转移的患者的生存率存在显着差异（OS：4.3 vs. 15.4 m，p = 0.031）。治疗原发肿瘤后，DOLC 大约是复发情况下的两倍（10.4 对 5.4 m，p = 0.032）。在单变量和多变量分析中，与根治性手术相比，保守治疗显着增加了局部复发的风险。副作用大多被归类为轻度至中度。在立体定向放射治疗和大分割后，RT 终止和丙氨酸转氨酶升高的频率显着降低。结论：放疗可实现CCA患者的局部控制。放疗的毒性是可控的，但需要密切的临床和实验室随访。
肿瘤资源治疗