Stereotactic body radiation therapy in cholangiocarcinoma: A systematic review

Rezarta Frakulli, Milly Buwenge, Gabriella Macchia, Silvia Cammelli, Francesco Deodato, Savino Cilla, Francesco Cellini, Gian Carlo Mattiucci, Silvia Bisello, Giovanni Brandi, Salvatore Parisi, Alessio G. Morganti

Risultato della ricerca: Contributo in rivistaArticolo in rivista

7 Citazioni (Scopus)

Abstract

Objective Stereotactic body radiation therapy (SBRT) has been used in the treatment of cholangiocarcinoma (CC) but toxicity and clinical results of SBRT in CC are still limited and sparse. Therefore, the aim of this systematic review was to analyze the results of SBRT in the setting of advanced CC. Methods A systematic literature search was conducted on PubMed, Scopus, and Cochrane library using the PRISMA methodology. Studies including at least 10 patients with diagnosis of advanced CC regardless of tumor site and other treatments were included. The primary outcome was overall survival (OS) and secondary endpoints were local control (LC) and toxicity rates. The ROBINS-I risk of bias tool was used. Results 10 studies (231 patients) fulfilled the selection criteria and were included in this review. All but one study showed moderate to serious risk of bias. Median follow up was 15 months (range: 7.8-64.0 months). Pooled 1 year OS was 58.3% (95% CI: 50.2-66.1%) and pooled 2 year OS was 35.5% (95% CI: 22.1-50.1%). Pooled 1 year LC was 83.4%, (95% CI: 76.5-89.4%). The reported toxicities were acceptable and manageable with only one treatment-related death. Conclusion The role of SBRT in CC is not yet supported by robust evidence in literature. However, within this limit, preliminary results seem almost comparable to the ones of standard chemotherapy or chemoradiation. Advances in knowledge SBRT seems effective in terms of LC with acceptable treatment-related toxicities. Therefore, SBRT can be considered a therapeutic option at least in selected patients with CC, possibly combined with adjuvant chemotherapy (CHT).
Lingua originaleEnglish
pagine (da-a)20180688-N/A
RivistaBritish Journal of Radiology
Volume92
DOI
Stato di pubblicazionePubblicato - 2019

Keywords

  • Bile Duct Neoplasms
  • Chemotherapy, Adjuvant
  • Cholangiocarcinoma
  • Humans
  • Radiosurgery
  • Survival Analysis

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