High Response Rate and Prolonged Survival of Unresectable Biliary Tract Cancer Treated With a New Combination Therapy Consisting of Intraarterial Chemotherapy Plus Radiotherapy

Goto, Takuma; Saito, Hiroya; Sasajima, Junpei; Kawamoto, Toru; Fujinaga, Akihiro; Utsumi, Tatsuya; Yanagawa, Nubuyuki; Hiramatsu, Kazuhide; Takamura, Akira; Sato, Hiroki; Fujibayashi, Shugo; Fujiya, Mikihiro

doi:10.3389/fonc.2020.597813

Cited by 4 publications

(8 citation statements)

References 22 publications

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“…Median OS survival and post-PSM multivariate Cox regression were compared for RT versus no surgery without RT, illustrating that palliative RT significantly improved survival and prognosis (Tables 4, 5). A recent study showed that combination therapy consisting of intraarterial chemotherapy plus external beam RT might further improve these results (33).…”

Section: Discussionmentioning

confidence: 99%

Associations between external beam radiotherapy and overall survival in patients with gallbladder cancer: A population-based study

Song

Kang

et al. 2022

Front. Public Health

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BackgroundThere is a lack of studies regarding radiotherapy (RT) in patients with gallbladder cancer (GBC) on the survival benefit after surgery and nonsurgical treatment. Therefore, this study evaluated the impact of external beam RT on the overall survival (OS) of patients with GBC in a real-world setting.MethodsPatients with GBC enrolled from the Surveillance, Epidemiology, and End Results (SEER) database were examined through Kaplan–Meier survival curves and multivariable Cox regression analyses.ResultsA total of 7,866 patients with GBC were screened for the current analysis, of whom 2,130 (27.1%) did not undergo RT or surgery, 209 (2.7%) underwent RT, 4,511 (57.3%) underwent surgery, and 1,016 (12.9%) underwent both RT and surgery. The median OS times were 4 months, 8 months, 16 months, and 21 months (p < 0.0001). OS was significantly different between adjuvant RT (p = 0.0002) and palliative RT (p < 0.0001). Multifactorial analysis (controlling for age, sex, year of diagnosis, marital status, race, grade, and stage) showed that both adjuvant RT (surgery and adjuvant RT vs. surgery alone; HR, 0.75; 95% CI, 0.69–0.82, p < 0.001) and palliative RT (RT alone vs. no treatment; HR, 0.80; 95% CI, 0.69–0.92, p = 0.003) had a significant impact on patient OS. The results remained stable following sensitivity analyses.ConclusionThe study results indicate that adjuvant and palliative radiation treatment was associated with a survival benefit. GBC patients can derive a survival benefit from external beam RT.

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Section: Discussionmentioning

confidence: 99%

Associations between external beam radiotherapy and overall survival in patients with gallbladder cancer: A population-based study

Song

Kang

et al. 2022

Front. Public Health

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“…Lastly, stent placement with hepatic arterial infusion (HAI) alone or combined with other therapies can be considered. Retrospective studies have shown improved OS when combining HAI with systemic chemotherapy or RT compared with either modality alone 28–31. A large multicenter retrospective study compared outcomes for stent placement with HAI and RFA versus stent alone and demonstrated longer median stent patency and survival times for the combination group versus the control group, without differences in adverse events between the 2 groups 32…”

Section: Methodsmentioning

confidence: 99%

“…Retrospective studies have shown improved OS when combining HAI with systemic chemotherapy or RT compared with either modality alone. [28][29][30][31] A large multicenter retrospective study compared outcomes for stent placement with HAI and RFA versus stent alone and demonstrated longer median stent patency and survival times for the combination group versus the control group, without differences in adverse events between the 2 groups. 32 In summary, treatment of MBO is typically performed using endoscopic or percutaneous drainage, usually with stent placement.…”

Section: Management Of Malignant Biliary Obstruction (Mbo)mentioning

confidence: 99%

American Radium Society (ARS) Appropriate Use Criteria (AUC) for Extrahepatic Cholangiocarcinoma

Tchelebi¹,

Jethwa

Levy³

et al. 2022

American Journal of Clinical Oncology

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Although uncommon, extrahepatic cholangiocarcinoma (EHCC) is a deadly malignancy, and the treatment approaches remain controversial. While surgery remains the only cure, few patients are candidates for resection up front, and there are high rates of both local and distant failure following resection. Herein, we systematically review the available evidence regarding treatment approaches for patients with EHCC, including surgery, radiation, and chemotherapy. The evidence regarding treatment outcomes was assessed using the Population, Intervention, Comparator, Outcome, and Study design (PICOS) framework. A summary of recommendations based on the available literature is outlined for specific clinical scenarios encountered by providers in the clinic to guide the management of these patients.

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“…Figure 1 shows the IAC + RT therapy schedule. The protocol was based on our previous report [19], but the off-label drugs epirubicin and etoposide were excluded, and the irradiation method was adapted to the current mainstream. First, blood flow modification and one-shot IAC of CDDP at 50 mg were performed for angiography.…”

Section: Treatmentmentioning

confidence: 99%

“…High RRs have been reported with intra-arterial chemotherapy (IAC) [13][14][15] and radiation therapy (RT) [16][17][18], but the efficacy of IAC with RT for unresectable BTC has not been established. Recently, our retrospective study noted the high efficacy of the combination therapy regimen of IAC and RT (IAC + RT) (mOS: 15.4 months, mPFS: 14.3 months, and RR: 40.4%) in cases of unresectable BTC [19].…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness of the Combination of Arterial Infusion Chemotherapy and Radiotherapy for Biliary Tract Cancer: A Prospective Pilot Study

Goto

Sato

Fujibayashi

et al. 2023

Cancers

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The standard treatment of unresectable biliary tract cancer (BTC) has shown an insufficient response rate (RR). Our retrospective setting revealed that a combination therapy consisting of intra-arterial chemotherapy plus radiation therapy (IAC + RT) provided a high RR and long-term survival benefits in unresectable BTC. This prospective study aimed to test the effectiveness and safety of IAC + RT as the first-line therapy. The regimen included one-shot IAC with cisplatin, 3–6 months of reservoir IAC (5-FU and cisplatin, q/week), and 50.4 Gy of external radiation. The primary endpoints include the RR, disease control rate, and adverse event rate. This study included seven patients with unresectable BTC without distant metastasis, with five cases classified as stage 4. RT was completed in all cases, and the median number of reservoir IAC sessions was 16. The RR was 57.1% for imaging and 71.4% for clinical assessment, and the disease control rate was 100%, indicating a high antitumor efficacy, which allowed two cases to be transferred to surgery. Five cases of leukopenia and neutropenia; four cases of thrombocytopenia; and two cases of hemoglobin depletion, pancreatic enzyme elevation, and cholangitis were observed, but with no treatment-related deaths. This study revealed a very high antitumor effect with IAC + RT for some unresectable BTC, and it could be useful for conversion therapy.

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High Response Rate and Prolonged Survival of Unresectable Biliary Tract Cancer Treated With a New Combination Therapy Consisting of Intraarterial Chemotherapy Plus Radiotherapy

Cited by 4 publications

References 22 publications

Associations between external beam radiotherapy and overall survival in patients with gallbladder cancer: A population-based study

Associations between external beam radiotherapy and overall survival in patients with gallbladder cancer: A population-based study

American Radium Society (ARS) Appropriate Use Criteria (AUC) for Extrahepatic Cholangiocarcinoma

The Effectiveness of the Combination of Arterial Infusion Chemotherapy and Radiotherapy for Biliary Tract Cancer: A Prospective Pilot Study

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