立体定向体部放疗用于不可切除的原发性或复发性胆管癌的疗效
Outcomes of stereotactic body radiotherapy for unresectable primary or recurrent cholangiocarcinoma.
作者信息
Jung Da Hoon, Kim Mi-Sook, Cho Chul Koo, Yoo Hyung Jun, Jang Won Il, Seo Young Seok, Paik Eun Kyung, Kim Kum Bae, Han Chul Ju, Kim Sang Bum
机构信息
Department of Radiation Oncology, Korea Institute of Radiological & Medical Sciences, Seoul, Korea.
Department of Internal Medicine, Korea Institute of Radiological & Medical Sciences, Seoul, Korea.
出版信息
Radiat Oncol J. 2014 Sep;32(3):163-9. doi: 10.3857/roj.2014.32.3.163. Epub 2014 Sep 30.
PURPOSE
To report the results of stereotactic body radiotherapy (SBRT) for unresectable primary or recurrent cholangiocarcinoma.
MATERIALS AND METHODS
From January 2005 through August 2013, 58 patients with unresectable primary (n = 28) or recurrent (n = 30) cholangiocarcinoma treated by SBRT were retrospectively analyzed. The median prescribed dose was 45 Gy in 3 fractions (range, 15 to 60 Gy in 1-5 fractions). Patients were treated by SBRT only (n = 53) or EBRT + SBRT boost (n = 5). The median tumor volume was 40 mL (range, 5 to 1,287 mL).
RESULTS
The median follow-up duration was 10 months (range, 1 to 97 months). The 1-year, 2-year overall survival rates, and median survival were 45%, 20%, and 10 months, respectively. The median survival for primary group and recurrent group were 5 and 13 months, respectively. Local control rate at 1-year and 2-year were 85% and 72%, respectively. Disease progression-free survival rates at 1-year and 2-year were 26% and 23%, respectively. In univariate analysis, ECOG performance score (0-1 vs. 2-3), treatment volume (<50 vs. ≥50 mL), and pre-SBRT CEA level (<5 vs. ≥5 ng/mL) were significant in overall survival rate. In multivariate analysis, ECOG score (p = 0.037) and tumor volume (p = 0.030) were statistically significant. In the recurrent tumor group, patients with >12 months interval from surgery to recurrence showed statistically significant higher overall survival rate than those with ≤12 months (p = 0.026). Six patients (10%) experienced ≥grade 3 complications.
CONCLUSION
SBRT can be considered as an effective local modality for unresectable primary or recurrent cholangiocarcinoma.
目的
报告立体定向体部放疗（SBRT）治疗不可切除的原发性或复发性胆管癌的结果。
材料与方法
回顾性分析2005年1月至2013年8月期间接受SBRT治疗的58例不可切除的原发性（n = 28）或复发性（n = 30）胆管癌患者。处方剂量中位数为45 Gy，分3次给予（范围为15至60 Gy，分1 - 5次给予）。患者仅接受SBRT治疗（n = 53）或外照射放疗（EBRT）+ SBRT增敏（n = 5）。肿瘤体积中位数为40 mL（范围为5至1287 mL）。
结果
中位随访时间为10个月（范围为1至97个月）。1年、2年总生存率及中位生存期分别为45%、20%和10个月。原发性组和复发性组的中位生存期分别为5个月和13个月。1年和2年的局部控制率分别为85%和72%。1年和2年的无疾病进展生存率分别为26%和23%。单因素分析中，东部肿瘤协作组（ECOG）体能状态评分（0 - 1 vs. 2 - 3）、治疗体积（<50 vs.≥50 mL）以及SBRT前癌胚抗原（CEA）水平（<5 vs.≥5 ng/mL）对总生存率有显著影响。多因素分析中，ECOG评分（p = 0.037）和肿瘤体积（p = 0.030）具有统计学意义。在复发性肿瘤组中，手术至复发间隔时间>12个月的患者总生存率显著高于间隔时间≤12个月的患者（p = 0.026）。6例患者（10%）出现≥3级并发症。
结论
SBRT可被视为治疗不可切除的原发性或复发性胆管癌的一种有效的局部治疗方式。
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