Defining the Role of Adjuvant Therapy: Cholangiocarcinoma and Gall Bladder Cancer
Defining the Role of Adjuvant Therapy: Cholangiocarcinoma and Gall Bladder Cancer
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DOI：
10.1016/j.semradonc.2014.01.001
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发表时间：
2014-04-01
影响因子：
3.5
通讯作者：
Thomas, Charles R., Jr.
中科院分区：
文献类型：
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作者：
Williams, Terence M.;Majithia, Lonika;Thomas, Charles R., Jr.
胆道癌是一种罕见的恶性肿瘤，包括胆囊癌和胆管癌。根据疾病的进展性和整体治疗的难治性，它们的预后通常很差。考虑到新辅助或辅助治疗，手术切除仍然是长期生存的最佳治疗方法。在这篇综述中，我们总结了辅助治疗的作用，包括放射治疗、化疗和同步放化疗，并结合现有的临床证据对每种治疗方案进行了总结。鉴于这些肿瘤的罕见，所提供的证据主要基于回顾研究、监测、流行病学和最终结果(SEER)数据库查询、单机构或多机构前瞻性研究以及辅助治疗研究的荟萃分析。目前，还没有一种被公认为护理标准的辅助疗法。随着分子靶向治疗和放射技术的进展，人们正在等待预期的、多机构的第二和第三阶段试验的结果，这将更好地确定治疗标准，并改善这类疾病的结果。(C)2014 Elsevier Inc.保留所有权利。
Biliary tract cancers are a rare subgroup of malignancies that include gall bladder carcinoma and cholangiocarcinoma. They generally carry a poor prognosis based on the advanced nature of disease at presentation and overall treatment refractoriness. Surgical resection remains the optimal treatment for long-term survival, with consideration of neoadjuvant or adjuvant therapies. In this review, we summarize the role of adjuvant treatments including radiation therapy, chemotherapy, and concurrent chemoradiation with the existing clinical evidence for each treatment decision. Given the rarity of these tumors, the evidence provided is based largely on retrospective studies, Surveillance, Epidemiological, and End Results (SEER) database inquiries, single- or multi-institutional prospective studies, and a meta-analysis of adjuvant therapy studies. Currently, there is no adjuvant therapy that has been agreed upon as a standard of care. Results from prospective, multi-institutional phase II and III trials are awaited, along with advances in molecular targeted therapies and radiation techniques, which will better define treatment standards and improve outcomes in this group of diseases. (c) 2014 Elsevier Inc. All rights reserved.