글로벌 연구동향
방사선종양학
- 2017년 04월호
[Br J Radiol.] Role of adjuvant radiotherapy for localized extrahepatic bile duct cancer.이화의대 / 김이준, 김규보*
- 출처
- Br J Radiol.
- 등재일
- 2017 Mar
- 저널이슈번호
- 90(1071):20160807. doi: 10.1259/bjr.20160807. Epub 2017 Feb 15.
- 내용
Abstract
OBJECTIVE:
To evaluate the benefit of adjuvant radiotherapy (RT) after surgical resection for extrahepatic bile duct (EHBD) cancer.
METHODS:
From 1997 to 2015, 59 patients with EHBD cancer were the subject of this study; 36 patients not undergoing adjuvant treatment after surgery (observation group) and 23 patients receiving adjuvant RT (RT group) were compared. Microscopic residual disease (R1) was in 9 (25%) patients and 5 (22%) patients, and macroscopic residual disease (R2) was in 2 (6%) patients and 6 (26%) patients in the observation and RT groups, respectively. Adjuvant RT was delivered to the tumour bed and regional lymph nodes up to 50.4 Gy (range, 45-61 Gy).
RESULTS:
With a median follow-up of 19 months, local recurrence was observed in 10 (28%) patients and 2 (9%) patients in the observation and RT groups, respectively. On univariate analysis, the 5-year local recurrence-free survival (LRFS) rates were 50% in the observation group and 54% in the RT group (p = 0.401). The 5-year overall survival (OS) rates were 29.3% in the observation group and 26.3% in the RT group (p = 0.602). On multivariable analysis, however, adjuvant RT significantly improved LRFS [hazard ratio (HR), 0.310; 95% confidence interval (CI), 0.100-0.963; p = 0.043] and had a trend towards increased OS (HR, 0.491; 95% CI, 0.219-1.102; p = 0.085). Resection margin (RM) status was also correlated with LRFS (HR for R1 6.134, 95% CI 2.051-18.344; and HR for R2 18.551, 95% CI 3.680-93.520; p < 0.001) and OS (HR for R1 1.816, 95% CI 0.853-3.867; and HR for R2 3.564, 95% CI 1.175-10.809; p = 0.054).
CONCLUSION:
RM status was a significant prognosticator of EHBD cancer, and adjuvant RT improved local control rate; thereby, survival rate might be increased. Advances in knowledge: The benefit of adjuvant RT in EHBD cancer was demonstrated via comparison with observation group.
Author information
Kim YJ1, Kim K1, Min SK2, Nam EM3.
1 Department of Radiation Oncology, Ewha Womans University School of Medicine, Seoul, Republic of Korea.
2 Department of Surgery, Ewha Womans University School of Medicine, Seoul, Republic of Korea.
3 Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea.
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편집위원
방사선종양학과 입장에서 특별한 역학을 하지 못하는 부분인 extrahepatic bile duct cancer에 대한 하나의 근거로 활용할 수 있는 연구라서 흥미로운 연구였습니다.
덧글달기닫기2017-04-05 12:20:26
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