The Technique of Intensity-Modulated Radiotherapy in the Treatment of Cholangiocarcinoma

Petera, J; Z, Papík; Zouhar, Milan; Jansa, Jan; Odrážka, Karel; Dvořák, Josef

doi:10.1177/030089160709300305

Cited by 3 publications

(4 citation statements)

References 19 publications

(16 reference statements)

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“…Wang et al (13) reported that GTV-to-CTV expansions of 4 mm for HCC are required to conceal any microinvasion and that this value could be reduced to 2 mm for about 95% patients with tumor dimensions #5 cm or AFP levels <400 mg/L. In past studies, CTV for IHC was defined as the GTV plus a margin of liver tissue that was $1 cm (6,(9)(10)(11) or 0.8 cm in length (12). Of these studies, one defined the target volume of four IHC cases (10), whereas the others considered the CTV of IHC was the same as that of liver metastases from colorectal cancer (9), locally advanced pancreatic cancer (11), or hepatocellular carcinoma (12).…”

Section: Discussionmentioning

confidence: 99%

“…In past studies, CTV for IHC was defined as the GTV plus a margin of liver tissue that was $1 cm (6,(9)(10)(11) or 0.8 cm in length (12). Of these studies, one defined the target volume of four IHC cases (10), whereas the others considered the CTV of IHC was the same as that of liver metastases from colorectal cancer (9), locally advanced pancreatic cancer (11), or hepatocellular carcinoma (12). This assumption is unreasonable, because these four types of carcinoma have different origins and histopathologic characteristics.…”

Section: Discussionmentioning

confidence: 99%

“…However, few studies have investigated the radiotherapy of unresectable IHC because of the low morbidity of this disease. Recent publications have failed to detect the extension from the GTV to the CTV (7,8), and others have defined the CTV as the GTV along with a margin of $1 cm (6,(9)(10)(11) or 0.8 cm (12). However, no study has analyzed IHC microextension and provided a system for determining GTV-to-CTV expansion in cases of unresectable IHC to be treated with EBRT.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Impact Factors for Microinvasion in Intrahepatic Cholangiocarcinoma: A Possible System for Defining Clinical Target Volume

Zeng

et al. 2010

International Journal of Radiation Oncology*Biology*Physics

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact Factors for Microinvasion in Intrahepatic Cholangiocarcinoma: A Possible System for Defining Clinical Target Volume

Zeng

et al. 2010

International Journal of Radiation Oncology*Biology*Physics

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“…Petera et al (18) emphasized the importance of intensity-modulated radiotherapy in a study of patients with inoperable GBC or cholangiocarcinoma who were treated with a dose of 50-60 Gy/25 fractions; this treatment achieved a median overall survival time of 10.4 months. The NCCN guidelines (7) recommend concurrent chemoradiation as well, but advise that the therapeutic agents applied should be limited to either fluorouracil or capecitabine.…”

Section: Discussionmentioning

confidence: 99%

Multidisciplinary collaboration in gallbladder carcinoma treatment: A case report and literature review

et al. 2016

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Abstract. Gallbladder carcinoma (GBC) is a rare and highly aggressive disease. The diagnosis of this cancer is difficult due to its occult onset. Hence, GBC is often detected late and at an advanced stage. Although physicians and researchers are continually working to improve the treatment for advanced-stage disease, GBC is usually associated with short survival times. The present study describes a case of GBC that was first diagnosed with accompanying cholecystolithiasis at the time of cholecystectomy. Cancer relapse occurred 1.5 years after the cholecystectomy. Multidisciplinary collaboration was involved in the decision-making process for the treatment of this aggressive recurrence, and the survival time was successfully extended to 26 months. Importantly, high-grade intraepithelial neoplasia and positive margins had previously been detected post-cholecystectomy at a different institution, but were ignored. Relapse may have been preventable had the cancer been diagnosed when it was initially observed. Taken together, these findings suggest that multidisciplinary collaboration should be considered for the management of advanced GBC, whereby patients will benefit from improved survival times. Furthermore, it is recommended that samples obtained from patients undergoing cholecystectomy should more carefully analyzed for evidence of cancerous or precancerous tissues. IntroductionGallbladder carcinoma (GBC) is rarely observed in Europe and the United States; however, the incidence and mortality rates in Asian countries, including China, Japan and Korea, are much higher (5.2/100,000, 4/100,000 and 5.6/100,000 individuals, respectively) (1). The majority of patients with GBCs are diagnosed at an advanced stage, which is due, in part, to the aggressive nature of the tumor and its rapid progression. Once the cancer has reached an advanced stage, curative surgical resection can no longer be performed (2), leaving any GBC patients with a poor prognosis; the median overall survival time has been reported at only 8.2 months and the 1-year survival rate for patients with stage IV disease is estimated at 1% (3,4).The current diagnostic methods for GBC include medical imaging and bile cytological analysis. Combination of the two modalities has been shown to facilitate improved rates of diagnosis (5), but the accuracy and utility of each of these strategies are limited by their reliance on a physician's subjective evaluation and how the sampled tissue is handled prior to testing. Thus, accurate and early diagnosis remains a significant clinical challenge. Furthermore, GBC usually presents with an occult onset, therefore malignancies are commonly detected incidentally during cholecystectomy for benign diseases (6). Neglecting to further pursue these incidental findings may lead to an undiagnosed GBC, thus allowing the cancer to become more advanced and life-threatening.The treatment options for late-stage GBC treatment include enrolling in a clinical trial, gemcitabine-or fluoropyrimidine-based chemotherapy, and/or supportive ...

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A Bile Duct Cancer Patient Whose Stent Shifted Significantly Over the Course of External Beam Radiotherapy

Yun

2011

J Korean Soc Ther Radiol Oncol

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The Technique of Intensity-Modulated Radiotherapy in the Treatment of Cholangiocarcinoma

Abstract: The intensity-modulated radiotherapy technique in bile duct carcinomas deserves further research and clinical evaluation.

Cited by 3 publications

References 19 publications

Impact Factors for Microinvasion in Intrahepatic Cholangiocarcinoma: A Possible System for Defining Clinical Target Volume

Impact Factors for Microinvasion in Intrahepatic Cholangiocarcinoma: A Possible System for Defining Clinical Target Volume

Multidisciplinary collaboration in gallbladder carcinoma treatment: A case report and literature review

A Bile Duct Cancer Patient Whose Stent Shifted Significantly Over the Course of External Beam Radiotherapy

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