Role of adjuvant radiotherapy in extrahepatic bile duct cancer: A multicenter retrospective study (Korean Radiation Oncology Group 18-14)
- 주제(키워드) Extrahepatic bile duct cancer , Adjuvant radiotherapy , Chemoradiotherapy
- 주제(기타) Oncology
- 설명문(일반) [Kim, Kyubo; Jung, Wonguen] Ewha Womans Univ, Coll Med, Dept Radiat Oncol, Seoul, South Korea; [Il Yu, Jeong] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Radiat Oncol, Seoul, South Korea; [Kim, Tae Hyun] Natl Canc Ctr, Ctr Proton Therapy, Goyang, South Korea; [Seong, Jinsil; Im, Jung Ho] Yonsei Univ, Coll Med, Dept Radiat Oncol, Seoul, South Korea; [Kim, Woo Chul] Inha Univ, Sch Med, Dept Radiat Oncol, Incheon, South Korea; [Choi, Jin Hwa] Chung Ang Univ, Coll Med, Dept Radiat Oncol, Seoul, South Korea; [Park, Younghee] Soonchunhyang Univ, Coll Med, Dept Radiat Oncol, Seoul, South Korea; [Jeong, Bae Kwon] Gyeongsang Natl Univ, Coll Med, Dept Radiat Oncol, Jinju, South Korea; [Kim, Byoung Hyuck] Seoul Natl Univ, Seoul Metropolitan Govt, Boramae Med Ctr, Dept Radiat Oncol, Seoul, South Korea; [Kim, Tae Gyu] Sungkyunkwan Univ, Sch Med, Samsung Changwon Hosp, Dept Radiat Oncol, Chang Won, South Korea; [Kim, Jin Hee] Keimyung Univ, Sch Med, Dept Radiat Oncol, Daegu, South Korea; [Park, Hae Jin] Hanyang Univ, Coll Med, Dept Radiat Oncol, Seoul, South Korea; [Shin, Hyun Soo; Im, Jung Ho] CHA Univ, Sch Med, Dept Radiat Oncol, Seongnam, South Korea; [Heo, Jin Seok] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Surg, Seoul, South Korea; [Park, Joon Oh] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Internal Med, Seoul, South Korea; [Jang, Jin-Young] Seoul Natl Univ, Coll Med, Dept Surg, Seoul, South Korea; [Oh, Do-Youn] Seoul Natl Univ, Coll Med, Dept Internal Med, Seoul, South Korea; [Woo, Sang Myung; Lee, Woo Jin] Natl Canc Ctr, Ctr Liver & Pancreatobiliary Canc, Goyang, South Korea; [Chie, Eui Kyu] Seoul Natl Univ, Coll Med, Dept Radiat Oncol, 101 Daehak Ro, Seoul 03080, South Korea
- 등재 SCIE, SCOPUS
- 발행기관 ELSEVIER SCI LTD
- 발행년도 2021
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000183625
- 본문언어 영어
- Published As http://dx.doi.org/10.1016/j.ejca.2021.07.045
- PubMed https://pubmed.ncbi.nlm.nih.gov/34474218
초록/요약
Purpose: To evaluate the role of adjuvant radiotherapy (RT) after curative resection in patients with extrahepatic bile duct (EHBD) cancer. Methods: Between January 2000 and December 2015, 1475 patients with EHBD cancer who underwent curative resection were accrued from 14 institutions in Korea. Among these, 959 patients did not receive any adjuvant therapy (RT(-) group), while 516 underwent postoperative RT with or without chemotherapy (RT(+) group). Results: The median age was 67 years. Nodal involvement was present in 482 patients (32.7%), and resection margin was involved in 293 patients (19.9%). RT(+) group had more patients with proximal tumours, advanced tumours, nodal involvement, perineural invasion, and involved resection margin than RT(-) group (all p < 0.001). With a median follow-up of 36 months, there were 211 locoregional recurrences, 307 distant metastases and 322 combined locoregional and distant failures. On multivariate analysis incorporating age, tumour location, differentiation, pT classification, pN classification, perineural invasion and resection margin, adjuvant RT was associated with improved overall survival (hazard ratio, 0.74; 95% confidence interval, 0.63-0.86; p < 0.001). When RT(+) group was separated into RT alone, concurrent chemoradiotherapy (CCRT) and CCRT followed by chemotherapy, the greatest benefit was observed in patients treated with CCRT followed by chemotherapy (hazard ratio, 0.52; 95% confidence interval, 0.41-0.68). Conclusions: Adjuvant RT combined with chemotherapy improved survival outcomes of resected EHBD cancer patients. Considering the greatest benefit observed in patients receiving CCRT followed by chemotherapy, a randomised controlled trial comparing chemotherapy alone and CCRT followed by chemotherapy is urgently needed. 2021 Elsevier Ltd. All rights reserved.
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