Williams Terence M, Majithia Lonika, Wang Samuel J, Thomas Charles R
Department of Radiation Oncology, The Ohio State University, Columbus, OH.
Department of Radiation Medicine, Oregon Health and Science University, Portland, OR.
Semin Radiat Oncol. 2014 Apr;24(2):94-104. doi: 10.1016/j.semradonc.2014.01.001.
Biliary tract cancers are a rare subgroup of malignancies that include gall bladder carcinoma and cholangiocarcinoma. They generally carry a poor prognosis based on the advanced nature of disease at presentation and overall treatment refractoriness. Surgical resection remains the optimal treatment for long-term survival, with consideration of neoadjuvant or adjuvant therapies. In this review, we summarize the role of adjuvant treatments including radiation therapy, chemotherapy, and concurrent chemoradiation with the existing clinical evidence for each treatment decision. Given the rarity of these tumors, the evidence provided is based largely on retrospective studies, Surveillance, Epidemiological, and End Results (SEER) database inquiries, single- or multi-institutional prospective studies, and a meta-analysis of adjuvant therapy studies. Currently, there is no adjuvant therapy that has been agreed upon as a standard of care. Results from prospective, multi-institutional phase II and III trials are awaited, along with advances in molecular targeted therapies and radiation techniques, which will better define treatment standards and improve outcomes in this group of diseases.
胆道癌是恶性肿瘤中的一个罕见亚组，包括胆囊癌和胆管癌。由于疾病在初诊时已处于晚期且总体治疗难治，它们通常预后较差。手术切除仍然是实现长期生存的最佳治疗方法，同时考虑新辅助或辅助治疗。在本综述中，我们总结了辅助治疗的作用，包括放射治疗、化疗以及同步放化疗，并阐述了每个治疗决策的现有临床证据。鉴于这些肿瘤的罕见性，所提供的证据主要基于回顾性研究、监测、流行病学和最终结果（SEER）数据库查询、单机构或多机构前瞻性研究以及辅助治疗研究的荟萃分析。目前，尚无被一致认可为标准治疗方案的辅助治疗方法。期待前瞻性、多机构II期和III期试验的结果，以及分子靶向治疗和放射技术的进展，这将更好地明确治疗标准并改善这类疾病的治疗效果。
