Radiochemotherapy with Gemcitabine in Unresectable Extrahepatic Cholangiocarcinoma: Long-term Results of a Phase II Study

Gian Carlo Mattiucci, Francesco Ardito, Mario Balducci, Francesco Deodato, Vincenzo Perri, Andrea Tringali, Maria Antonietta Gambacorta, Felice Giuliante, Vincenzo Valentini, Rosa Autorino, Gabriella Macchia, Giovanna Mantini, Luca Tagliaferri, Alessio Giuseppe Morganti

Risultato della ricerca: Contributo in rivistaArticolo in rivista

21 Citazioni (Scopus)

Abstract

PURPOSE:To evaluate the outcome of patients affected by unresectable extrahepatic cholangiocarcinoma treated with radiotherapy (ERT) and concurrent gemcitabine-based chemotherapy with or without intraluminal brachytherapy (BT). PATIENTS AND METHODS: Twenty-seven patients underwent weekly gemcitabine (100 mg/m(2)) as a 24-h infusion during the course of three-dimensional radiotherapy (50.4 Gy to the tumor and 39.6 Gy to the nodes). Among them, certain patients received a boost of intraluminal high-dose rate (HDR) brachytherapy with 192 Ir. The outcome of patients was evaluated in terms of response to therapy, local control (LC), overall survival (OS) and toxicity. RESULTS: We analyzed a total of 27 patients with the diagnosis of unresectable, non-metastatic adenocarcinoma of the extrahepatic biliary ducts, treated with radiochemotherapy with gemcitabine. After a dose of 50 Gy, a boost of HDR intraluminal brachytherapy was administered in 6 patients (22%): 4 patients received 15 Gy and 2 patients 20 Gy. With a median follow-up of 16 months (range=3-52 months), for the entire group, 2-year LC was 29% (median=12 months), 2-year MFS was 36% (median 16 months). Two-year and three-year OS were 27% and 7% respectively, with a median of 14 months. Toxicities were acceptable. Median OS in patients treated with brachytherapy boost was 21 months versus 14 months for the group treated with gemcitabine-based radiochemotherapy only; 2-year LC was 53% versus 25%, respectively. CONCLUSION: Gemcitabine appears to be a potent radiation sensitizer, and when combined with radiation therapy, it shows encouraging tumor response. Moreover, patients treated with a boost of brachytherapy after radiochemotherapy seem to have a better local control with an acceptable toxicity. Further investigation is warranted to confirm these data and define the optimal combined treatments.
Lingua originaleEnglish
pagine (da-a)737-740
Numero di pagine4
RivistaAnticancer Research
Volume36
Stato di pubblicazionePubblicato - 2016

Keywords

  • Aged
  • Antimetabolites, Antineoplastic
  • Bile Duct Neoplasms
  • Brachytherapy
  • Chemoradiotherapy
  • Cholangiocarcinoma
  • Deoxycytidine
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Proportional Hazards Models
  • Radiation-Sensitizing Agents
  • Radiotherapy Dosage
  • Radiotherapy, Conformal
  • Time Factors
  • Treatment Outcome
  • gemcitabine
  • radiotherapy

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