Clinical outcomes and toxicity using stereotactic body radiotherapy (SBRT) for advanced cholangiocarcinoma.
Clinical outcomes and toxicity using stereotactic body radiotherapy (SBRT) for advanced cholangiocarcinoma.
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DOI：
10.1186/1748-717x-7-67
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发表时间：
2012-05-03
期刊：
影响因子：
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通讯作者：
Haddock MG
中科院分区：
文献类型：
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作者：
Barney BM;Olivier KR;Miller RC;Haddock MG
报告SBRT治疗胆管癌的单机构临床结局和毒性。从2009年3月至2011年7月，10例患者的12个不可切除的原发性（n = 6）或复发性（n = 6）胆管癌病灶接受了腹部SBRT。治疗部位包括肝脏（n = 10）、腹部淋巴结（n = 1）和肾上腺（n = 1）。SBRT在一周内每天连续进行三次（n = 2）或五次（n = 10）。中位处方剂量为55戈伊（范围，45-60）。根据RECIST v.1.1对治疗应答进行分级，根据CTCAE v.4.0对毒性进行评分。使用Kaplan-Meier方法分析数据，以确定局部控制率（LC）、无远处进展率（FFDM）和总生存率（OS）。中位随访时间为14个月（范围：2-26个月）。LC（定义为SBRT视野内无进展）为100%，但4例接受肝内部位治疗的患者在肝脏其他部位发生进展。6个月和12个月时FFDM的估计值分别为73%和31%。疾病复发部位包括肝脏（n = 3）、肝脏和淋巴结（n = 1）、肝脏和肺（n = 1）、淋巴结（n = 1）和肠系膜（n = 1）。队列在6个月和12个月时的OS估计值分别为83%和73%。最常见的≥2级早期毒性为2级恶心和呕吐（n = 5）和胃肠道疼痛（n = 2）。晚期≥2次毒性包括2级胃肠道疼痛（n = 3）、3级胆管狭窄（n = 1）和5级肝衰竭（n = 1）。SBRT显示出作为适当选择的胆管癌患者的有效局部治疗的前景。需要进一步随访以更好地量化SBRT相关晚期并发症的风险。
To report single-institutional clinical outcomes and toxicity with SBRT for cholangiocarcinoma. From March 2009 to July 2011, 10 patients with 12 unresectable primary (n = 6) or recurrent (n = 6) cholangiocarcinoma lesions underwent abdominal SBRT. Sites treated included liver (n = 10), abdominal lymph nodes (n = 1), and adrenal gland (n = 1). SBRT was delivered in three (n = 2) or five (n = 10) consecutive daily fractions over one week. The median prescription dose was 55 Gy (range, 45–60). Treatment response was graded by RECIST v.1.1, and toxicities were scored by CTCAE v.4.0. Data was analyzed using the Kaplan-Meier method to determine rates of local control (LC), freedom from distant progression (FFDM) and overall survival (OS). The median follow-up was 14 months (range, 2–26 months). LC, defined as freedom from progression within the SBRT field, was 100%, but four patients treated to intrahepatic sites experienced progression elsewhere in the liver. Estimates for FFDM at 6 and 12 months were 73% and 31%, respectively. Sites of disease relapse included liver (n = 3), liver and lymph nodes (n = 1), liver and lungs (n = 1), lymph nodes (n = 1), and mesentery (n = 1). OS estimates for the cohort at 6 and 12 months were 83% and 73%, respectively. The most common Grade ≥2 early toxicities were Grade 2 nausea and vomiting (n = 5) and gastrointestinal pain (n = 2). Late ≥2 toxicities included Grade 2 gastrointestinal pain (n = 3), Grade 3 biliary stenosis (n = 1), and Grade 5 liver failure (n = 1). SBRT shows promise as an effective local therapy for properly-selected patients with cholangiocarcinoma. Further follow-up is needed to better quantify the risk of late complications associated with SBRT.