Three-Dimensional Conformal Radiotherapy for Unresectable or Post-Operative Residual Biliary Tract Carcinoma

無法切除或術後殘餘的膽道癌之三度空間順形放射治療

黃俊杰(Chun-Chieh Huang) ； 黃英彥(Eng-Yen Huang) ； 方富民(Fu-Min Fang) ； 王重榮(Chong-Jong Wang) ； 陳惠君(Hui-Chun Chen) ； 黃郁傑(Yu-Jie Huang) ； 汪昶佑(Chang-Yu Wang) ； 王友明(Yu-Ming Wang) ； 許軒之(Hsuan-Chih Hsu)

《放射治療與腫瘤學》 18卷2期 (2011/06) Pp. 97-110

https://doi.org/10.6316/TRO/201118(2)97

摘要

Purpose: To evaluate the efficacy of three-dimensional conformal radiotherapy (3D-CRT) for unresectable or post-operative residual biliary tract carcinoma (BTC).Materials and Methods: From September 1997 to August 2005, twenty-eight patients with localized unresectable (23 patients) or post-operative residual (5 patients) BTC were treated by 3D-CRT. The median radiation dose was 62.0 Gy (21.6-70.0 Gy/1.8-2.5 Gy). Seven patients also underwent chemotherapy. The median follow-up time for all patients was 6.4 months.Results: The median progression-free survival (PFS) was 5.8 months and the 2-year actuarial PFS rate was 10.7%. The median overall survival (OS) was 8.4 months and the 2-year actuarial OS rate was 23.1%. In univariate analysis, both OS and PFS strongly correlate with the performance status, jaundice, radiation dose and serum carbohydrate antigen 19-9 level. The PFS also significantly associates with unresectable tumor status. After multivariate analysis: good performance status (ECOG: 0 or 1) and higher radiation dose (＞50.0 Gy) were two independent prognostic factors which showed for patients with both PFS (p＜0.001 and p=0.046, respectively) and OS (p＜0.001 and p=0.010, respectively). The overall incidence of upper gastrointestinal bleeding in patients without any previous peptic ulcer history was 18.2% and the complications were medically manageable.Conclusions: The study demonstrated that performance status and RT dose are two predictors for outcome in patients treated with 3D-CRT for unresectable or postoperative residual BTC.

關鍵字

放射治療 ； 膽道癌 ； 無法切除 ； 術後殘餘

並列摘要

Purpose: To evaluate the efficacy of three-dimensional conformal radiotherapy (3D-CRT) for unresectable or post-operative residual biliary tract carcinoma (BTC).Materials and Methods: From September 1997 to August 2005, twenty-eight patients with localized unresectable (23 patients) or post-operative residual (5 patients) BTC were treated by 3D-CRT. The median radiation dose was 62.0 Gy (21.6-70.0 Gy/1.8-2.5 Gy). Seven patients also underwent chemotherapy. The median follow-up time for all patients was 6.4 months.Results: The median progression-free survival (PFS) was 5.8 months and the 2-year actuarial PFS rate was 10.7%. The median overall survival (OS) was 8.4 months and the 2-year actuarial OS rate was 23.1%. In univariate analysis, both OS and PFS strongly correlate with the performance status, jaundice, radiation dose and serum carbohydrate antigen 19-9 level. The PFS also significantly associates with unresectable tumor status. After multivariate analysis: good performance status (ECOG: 0 or 1) and higher radiation dose (＞50.0 Gy) were two independent prognostic factors which showed for patients with both PFS (p＜0.001 and p=0.046, respectively) and OS (p＜0.001 and p=0.010, respectively). The overall incidence of upper gastrointestinal bleeding in patients without any previous peptic ulcer history was 18.2% and the complications were medically manageable.Conclusions: The study demonstrated that performance status and RT dose are two predictors for outcome in patients treated with 3D-CRT for unresectable or postoperative residual BTC.

並列關鍵字

Radiotherapy ； Biliary tract carcinoma ； Unresectable ； Post-operative residual