방사선종양학

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  • 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

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    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.

    Department of Radiation Oncology, Ewha Womans University School of Medicine, Seoul, Republic of Korea.

    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.

  • 편집위원

    방사선종양학과 입장에서 특별한 역학을 하지 못하는 부분인 extrahepatic bile duct cancer에 대한 하나의 근거로 활용할 수 있는 연구라서 흥미로운 연구였습니다.

    덧글달기2017-04-05 12:20:26

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