Radiation therapy in cholangiocellular carcinomas
Radiation therapy in cholangiocellular carcinomas
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DOI：
10.1016/j.bpg.2016.08.003
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发表时间：
2016-08-01
影响因子：
3.2
通讯作者：
Seufferlein, Thomas
中科院分区：
文献类型：
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作者：
Brunner, Thomas B.;Seufferlein, Thomas
胆管癌可以发生在胆道的所有部分，这对治疗有影响。手术是治疗的主要手段，但局部复发是一个主要问题。因此，在试验中对放化疗辅助治疗进行了测试。在肝外胆管癌和胆囊癌中进行的SWOG-S 0809放化疗试验方案目前可视为该适应症的最高水平证据。与仅常规分次放疗发挥作用的辅助治疗相比，立体定向体部放疗（SBRT）由于能够给予更高剂量的放疗以改善局部控制，因此今天已成为确定性治疗的放化疗的有力替代方案。也经常采用与化疗的顺序组合。然而，一般来说，胆管癌是一种孤儿疾病，未来的临床试验将提高现有的证据水平。(C)2016爱思唯尔有限公司版权所有
Cholangiocarcinoma can arise in all parts of the biliary tract and this has implications for therapy. Surgery is the mainstay of therapy however local relapse is a major problem. Therefore, adjuvant treatment with chemoradiotherapy was tested in trials. The SWOG-S0809 trial regimen of chemoradiotherapy which was tested in extrahepatic cholangiocarcinoma and in gallbladder cancer can currently be regarded as highest level of evidence for this indication. In contrast to adjuvant therapy where only conventionally fractionated radiotherapy plays a role, stereotactic body radiotherapy (SBRT) today has become a powerful alternative to chemoradiotherapy for definitive treatment due to the ability to administer higher doses of radiotherapy to improve local control. Sequential combinations with chemotherapy are also frequently employed. Nevertheless, in general cholangiocarcinoma is an orphan disease and future clinical trials will have to improve the available level of evidence. (C) 2016 Elsevier Ltd. All rights reserved.