Chemoradiation and brachytherapy in biliary tract carcinoma: Long-term results

Journal Article · Wed Feb 01 04:00:00 EST 2006 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2005.0· OSTI ID:20793308

Deodato, Francesco ^[1]; Clemente, Gennaro ^[2]; Mattiucci, Gian Carlo ^[3]; Macchia, Gabriella ^[1]; Costamagna, Guido ^[4]; Giuliante, Felice ^[2]; Smaniotto, Daniela ^[3]; Luzi, Stefano ^[3]; Valentini, Vincenzo ^[3]; Mutignani, Massimiliano ^[4]; Nuzzo, Gennaro ^[2]; Cellini, Numa ^[3]; Morganti, Alessio G ^[1]

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1. Department of Radiation Therapy, Centro di Ricerca e Formazione ad Alta Tecnologia nelle Scienze Biomediche, Universita Cattolica del Sacro Cuore, Campobasso (Italy)
2. Department of Surgery, Policlinico A. Gemelli, Universita Cattolica del Sacro Cuore, Rome (Italy)
3. Department of Radiation Therapy, Policlinico A. Gemelli, Universita Cattolica del Sacro Cuore, Rome (Italy)
4. Department of Surgical Digestive Endoscopy, Universita Cattolica del Sacro Cuore, Rome (Italy)

Purpose: To evaluate long-term effects of chemoradiation and intraluminal brachytherapy in terms of local control, disease-free survival, overall survival, and symptom relief in patients with unresectable or residual extrahepatic biliary carcinoma. Methods and Materials: Twenty-two patients with unresectable (17 patients) or residual (5 patients) nonmetastatic extrahepatic bile tumors received external beam radiation therapy (39.6-50.4 Gy) between 1991 and 1997. In 21 patients, 5-fluorouracil (96-h continuous infusion, Days 1-4, 1,000 mg/m{sup 2}/day) was administered. Twelve patients received a boost of intraluminal brachytherapy with {sup 192}Ir wires (30-50 Gy) 1 cm from the source axis. Results: During external beam radiotherapy, 10 patients (45.4%) developed Grade 1 to 2 gastrointestinal toxicity. In patients with unresectable tumor who could be evaluated, the clinical response was 28.6% (4 of 14). Two patients showed complete response. In all 22 patients, median durations of local control, disease-free survival, and overall survival were 44.5 months, 16.3 months, and 23.0 months, respectively. Two patients who received external beam radiation therapy and intraluminal brachytherapy developed late duodenal ulceration. In patients with unresectable tumors, median survival was 13.0 months and 22.0 months in those treated with and without brachytherapy, with 16.7% and no 5-year survival, respectively (p = 0.607). Overall 5-year survival was 18.0%: 40% and 11.7% in patients treated with partial resection and in those with unresectable tumor, respectively (p = 0.135). Conclusion: This study confirmed the role of concurrent chemoradiation in advanced biliary carcinoma; the role of intraluminal brachytherapy boost remains to be further analyzed in larger clinical trials.

• OSTI ID: 20793308
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 2 Vol. 64; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BILE
BILIARY TRACT
BRACHYTHERAPY
CARCINOMAS
CHEMOTHERAPY
CLINICAL TRIALS
IRIDIUM 192
PATIENTS
SURGERY
SYMPTOMS
TOXICITY
URACILS