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방사선량의 증량으로 국소제어율이 통계학적으로 유의하게 향상됨을 보여준 그림입니다. 아울러, 기존 방사선량군에서 분할 치료와 연속 치료간에 차이가 없음도 확인하였습니다.

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Abstract

PURPOSE: 

This study was conducted to evaluate the impact of radiation dose after margin involved resection in patients with extrahepatic bile duct cancer.

METHODS: 

Among the 251 patients who underwent curative resection followed by adjuvant chemoradiotherapy, 86 patients had either invasive carcinoma (n = 63) or carcinoma in situ (n = 23) at the resected margin. Among them, 54 patients received conventional radiation dose (40-50.4 Gy) and 32 patients received escalated radiation dose (54-56 Gy).

RESULTS: 

Escalated radiation dose was associated with improved locoregional control (5yr rate, 73.8% vs. 47.1%, p = 0.069), but not disease-free survival (5yr rate, 43.4% vs. 32.6%, p = 0.490) and overall survival (5yr rate, 40.6% vs. 29.6%, p = 0.348). In multivariate analysis for locoregional control, invasive carcinoma at the margin (HR 2.957, p = 0.032) and escalated radiation dose (HR 0.394, p = 0.047) were independent prognostic factors. No additional gastrointestinal toxicity was observed in escalated dose group.

CONCLUSIONS: 

Delivery of radiation dose ≥ 54 Gy was well tolerated and associated with improved locoregional control, but not with overall survival after margin involved resection. Further validation study is warranted.​ 

Author information

Kim BH1,2, Chie EK1, Kim K3, Jang JY4, Kim SW4, Oh DY5, Bang YJ5, Ha SW1.​

1Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea.2Division of Biological Warfare Preparedness and Response, Armed Forces Medical Research Institute, Daejeon, Republic of Korea.3Department of Radiation Oncology, Ewha Womans University School of Medicine, Seoul, Republic of Korea.4Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.5Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.  

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