Sagawa Noriaki, Kondo Satoshi, Morikawa Toshiaki, Okushiba Shunichi, Katoh Hiroyuki
Department of Surgical Oncology, Division of Cancer Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Surg Today. 2005;35(7):548-52. doi: 10.1007/s00595-005-2989-4.
Some studies suggest that giving radiation therapy after surgery for hilar cholangiocarcinoma improves the survival rate; however, many of these studies did not specify numbers of subjects or provide an impartial analysis. Thus, we evaluated the effectiveness of radiation therapy as adjuvant treatment after surgery and attempted to establish appropriate adaptation standards.
We reviewed the records of 69 patients who underwent surgery for hilar cholangiocarcinoma between June 1980 and April 1998. Thirty-nine patients were treated with surgery followed by radiation therapy and 30 were treated with surgery alone.
The clinicopathologic features that might have influenced prognosis were similar in the patients who received radiation therapy and those who did not. Radiation as adjuvant therapy did not have a beneficial effect on overall survival (P = 0.554, log-rank test); however, it tended to improve survival in the group of patients who underwent curative resection for with p-stage III or IVa disease (P = 0.042, log-rank test).
Radiation therapy after surgery did not show any clinical benefits for patients with hilar cholangiocarcinoma. However, it may be effective as adjuvant therapy after curative resection in a small subgroup of patients with p-stage III or IVa disease.
一些研究表明，肝门部胆管癌术后进行放射治疗可提高生存率；然而，这些研究大多未明确受试者数量或提供公正的分析。因此，我们评估了放射治疗作为术后辅助治疗的有效性，并试图制定合适的适应标准。
我们回顾了1980年6月至1998年4月期间69例行肝门部胆管癌手术患者的记录。39例患者接受手术加放射治疗，30例仅接受手术治疗。
接受放射治疗和未接受放射治疗的患者中，可能影响预后的临床病理特征相似。放射治疗作为辅助治疗对总生存期无有益影响（P = 0.554，对数秩检验）；然而，对于p分期为III期或IVa期且接受根治性切除的患者组，放射治疗倾向于改善生存期（P = 0.042，对数秩检验）。
手术后继以放射治疗对肝门部胆管癌患者未显示出任何临床益处。然而，对于一小部分p分期为III期或IVa期的患者，放射治疗作为根治性切除后的辅助治疗可能有效。
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