High Response Rate and Prolonged Survival of Unresectable Biliary Tract Cancer Treated With a New Combination Therapy Consisting of Intraarterial Chemotherapy Plus Radiotherapy.
Abstract | SYNOPSIS: PURPOSE: METHODS: We retrospectively reviewed 52 BTC cases treated with AI+RT and analyzed the anti- tumor effect, survival time and adverse events. The AI+RT regimen consisted of one-shot intraarterial chemotherapy (AI) at the first angiography session, almost 6 months of reservoir AI (5-FU and cisplatin, q/week) and external radiation with a maximum dose of 50.6 Gy. RESULTS: The response rate and disease control rate were high, at 40.4% and 96.2%, respectively, and the median overall and progression-free survival time were 463 and 431 days; thus, long-term survival was achieved. A univariate analysis identified 12 prognostic factors, and a performance status of 2 (hazard ratio [HR]: 4.82, p=0.02), jaundice (HR: 3.22, p<0.01), peritoneal dissemination (HR: 22.5, p<0.01), number of AI (HR: 0.35, p=0.01) and response to AI+RT (HR: 0.23, p<0.01) were extracted as significant prognostic factors in a multivariate analysis. The following: grade ≥3 adverse events occurred: leucopenia (11.5%), neutropenia (1.9%), anemia (15.4%), thrombocytopenia (11.5%), anorexia (3.8%), gastroduodenal ulcer (25.0%), and cholangitis (23.1%). There were no cases of treatment-related death. CONCLUSIONS: AI+RT was shown to contribute to a high response rate and prolonged survival in patients with unresectable BTC. A sufficient number of AI and the response to this therapy were thought to be significant prognostic factors in patients receiving AI+RT. Advances in multidisciplinary therapies, such as AI+RT, which was described in the present study, are also considered to be important for the future.
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Authors | Takuma Goto, Hiroya Saito, Junpei Sasajima, Toru Kawamoto, Akihiro Fujinaga, Tatsuya Utsumi, Nubuyuki Yanagawa, Kazuhide Hiramatsu, Akio Takamura, Hiroki Sato, Shugo Fujibayashi, Mikihiro Fujiya |
Journal | Frontiers in oncology
(Front Oncol)
Vol. 10
Pg. 597813
( 2020)
ISSN: 2234-943X [Print] Switzerland |
PMID | 33312956
(Publication Type: Journal Article)
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Copyright | Copyright © 2020 Goto, Saito, Sasajima, Kawamoto, Fujinaga, Utsumi, Yanagawa, Hiramatsu, Takamura, Sato, Fujibayashi and Fujiya. |
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