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Postoperative radiotherapy dose correlates with locoregional control in patients with locoregional control in patients with extra-hepatic bile duct cancer

Authors
 Jung Ho Im  ;  Jinsil Seong  ;  Jeongshim Lee  ;  Yong Bae Kim  ;  Ik Jae Lee  ;  Jun Sung Park  ;  Dong Sup Yoon  ;  Kyung Sik Kim  ;  Woo Jung Lee 
Citation
 RADIATION ONCOLOGY JOURNAL, Vol.32(1) : 7-13, 2014 
Journal Title
RADIATION ONCOLOGY JOURNAL
ISSN
 2234-1900 
Issue Date
2014
Keywords
Adjuvant radiotherapy ; Bile duct neoplasms ; Radiotherapy dosage
Abstract
PURPOSE:
To evaluate the results of postoperative radiotherapy in patients with extra-hepatic bile duct cancer (EHBDC) and identify the prognostic factors for local control and survival.
MATERIALS AND METHODS:
Between January 2001 and December 2010, we retrospectively reviewed the cases of 70 patients with EHBDC who had undergone curative resection and received postoperative radiotherapy. The median radiation dose was 50.4 Gy (range, 41.4 to 54 Gy). The resection margin status was R0 in 30 patients (42.9%), R1 in 25 patients (35.7%), and R2 in 15 patients (21.4%).
RESULTS:
The 5-year rates of overall survival (OS), event-free survival (EFS), and locoregional control (LRC) for all patients were 42.9%, 38.3%, and 61.2%, respectively. The major pattern of failure was distant relapses (33 patients, 47.1%). A multivariate analysis showed that the postradiotherapy CA19-9 level, radiation dose (≥50 Gy), R2 resection margins, perineural invasion, and T stage were the significant prognostic factors for OS, EFS, and LRC. OS was not significantly different between the patients receiving R0 and R1 resections, but was significantly lower among those receiving R2 resection (54.6%, 56.1%, and 7.1% for R0, R1, and R2 resections, respectively).
CONCLUSION:
In patients with EHBDC who had undergone curative resection, a postoperative radiotherapy dose less than 50 Gy was suboptimal for OS and LRC. Higher radiation doses may be needed to obtain better LRC. Further investigation of novel therapy or palliative treatment should be considered for patients receiving R2 resection.
Files in This Item:
T201403168.pdf Download
DOI
10.3857/roj.2014.32.1.7
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Sik(김경식) ORCID logo https://orcid.org/0000-0001-9498-284X
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0001-7573-6862
Park, Joon Seong(박준성) ORCID logo https://orcid.org/0000-0001-8048-9990
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Yoon, Dong Sup(윤동섭) ORCID logo https://orcid.org/0000-0001-6444-9606
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Lee, Ik Jae(이익재) ORCID logo https://orcid.org/0000-0001-7165-3373
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/99765
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