Yang Liang, Feng Fei-ling, Zhou Hai-hua, Sun Yong-jian, Meng Yan
Radiation Center of East Hepatobiliary Hospital, Shanghai 200438, China.
Zhonghua Zhong Liu Za Zhi. 2013 Jul;35(7):534-9.
To summarize the experiences in gallbladder cancer treatment, evaluate the efficacy of postoperative radiotherapy, and investigate the method of improving the survival of gallbladder cancer patients.
One hundred and twenty-seven gallbladder cancer patients, treated in our center by radical resection (84 cases) and combined with postoperative radiotherapy (43 cases), between June 2003 to December 2009 were included in this study. Their clinical data and follow-up results were retrospectively analyzed. According to AJCC staging criteria, the survival time and 1-, 3- and 5-year survival rates of the surgery group and the postoperative radiotherapy group at the different pathological stages and resection margin status were compared.
The median survival time of postoperative radiotherapy patients in stage III was 16.9 months, and the 1-year, 3-year, and 5-year survival rates were 55.7%, 23.5% and 18.2%, respectively, significantly higher than that of the simple operation group ( median survival time 14.3 months, and 1-year, 3-year, 5-year survival rates 42.7%, 22.6% and 16.7%, respectively) (P<0.05). The median survival time of postoperative radiotherapy patients in stage IV, the median survival time was 9.7 months in the postoperative radiotherapy group and 6.3 months in the simple surgery group, and the 1-year survival rates were 14.2% and 9.8%, the 3-year survival rates were 7.2% and 3.9%, the 5-year survival rates were 7.2% and 1.9%, respectively, all showing a statistically significant difference (P<0.05). Among the stage III and IVpatients, all the 1-, 3- and 5-year survival rates of the postoperative radiotherapy group were higher than that of the simple R0 and R1 surgical resection group (all P<0.05), but with a non-significant difference between the stageIandIIpatients (P>0.05). The main side effects in postoperative radiotherapy patients including nausea, vomiting and abdominal pain, all were successfully alleviated by symptomatic and supportive therapy, and the radiotherapy was successfully completed.
With regard to the gallbladder cancer patients in stage III and IV, the survival rate can be obviously increased by postoperative radiotherapy. However, for patients in stageIand II, whether postoperative radiotherapy significantly improves the survival or not, needs to be further validated in larger scale studies.
总结胆囊癌治疗经验，评估术后放疗的疗效，并探讨提高胆囊癌患者生存率的方法。
本研究纳入了2003年6月至2009年12月期间在本中心接受根治性切除术（84例）并联合术后放疗（43例）的127例胆囊癌患者。对其临床资料及随访结果进行回顾性分析。根据美国癌症联合委员会（AJCC）分期标准，比较手术组和术后放疗组在不同病理分期及切缘状态下的生存时间、1年、3年和5年生存率。
Ⅲ期患者术后放疗组的中位生存时间为16.9个月，1年、3年和5年生存率分别为55.7%、23.5%和18.2%，显著高于单纯手术组（中位生存时间14.3个月，1年、3年、5年生存率分别为42.7%、22.6%和16.7%）（P<0.05）。Ⅳ期患者术后放疗组的中位生存时间为9.7个月，单纯手术组为6.3个月，1年生存率分别为14.2%和9.8%，3年生存率分别为7.2%和3.9%，5年生存率分别为7.2%和1.9%，均有统计学差异（P<0.05）。在Ⅲ期和Ⅳ期患者中，术后放疗组的1年、3年和5年生存率均高于单纯R0和R1手术切除组（均P<0.05），但Ⅰ期和Ⅱ期患者之间差异无统计学意义（P>0.05）。术后放疗患者的主要副作用包括恶心、呕吐和腹痛，经对症支持治疗均成功缓解，放疗顺利完成。
对于Ⅲ期和Ⅳ期胆囊癌患者，术后放疗可明显提高生存率。然而，对于Ⅰ期和Ⅱ期患者，术后放疗是否能显著提高生存率，需要在更大规模的研究中进一步验证。
