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Multimodality treatment in unresectable cholangiocarcinoma
PURPOSE: Cholangiocarcinomas (CCs) are rare and highly malignant cancers. Although there are different treatment protocols for treatment of cholangiocarcinoma, we aimed to investigate a survival rate of patients with unresectable extrahepatic CCs (ECCs) receiving multimodality therapeutic protocol (...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Termedia Publishing House
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7207240/ https://www.ncbi.nlm.nih.gov/pubmed/32395137 http://dx.doi.org/10.5114/jcb.2020.94582 |
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author | Aghili, Mahdi Saberi, Hazhir zadeh, Mahtab Mojtahed Jafari, Fatemeh Mehrabinejad, Mohammad-Mehdi Dashti, Habibollah Saberi, Pejman Yazdi, Niloofar Ayoobi |
author_facet | Aghili, Mahdi Saberi, Hazhir zadeh, Mahtab Mojtahed Jafari, Fatemeh Mehrabinejad, Mohammad-Mehdi Dashti, Habibollah Saberi, Pejman Yazdi, Niloofar Ayoobi |
author_sort | Aghili, Mahdi |
collection | PubMed |
description | PURPOSE: Cholangiocarcinomas (CCs) are rare and highly malignant cancers. Although there are different treatment protocols for treatment of cholangiocarcinoma, we aimed to investigate a survival rate of patients with unresectable extrahepatic CCs (ECCs) receiving multimodality therapeutic protocol (MTP) (biliary drainage + external beam radiotherapy [EBRT] + brachytherapy and systemic chemotherapy). Similarly, we aimed to identify a relationship between survival time and associated factors in treatment outcome. MATERIAL AND METHODS: This retrospective study was performed on patients with ECC, who were referred to our university hospital between 2012 and 2015, and their imaging were diagnosed as unresectable. Patients underwent MTP including internal-external drainage catheter (F10-12) with insertion under fluoroscopy guidance, EBRT with 25-28 fractions and concurrent chemotherapy using capecitabine (Xeloda) 825 mg/m(2) at the days of radiotherapy, followed by brachytherapy (BT) with iridium-192 ((192)Ir) or cobalt-60 ((60)Co) sources for 21 Gy in 3 consecutive days. Demographic variables, complications, laboratory tests, imaging findings, and survival time (OS – overall survival after diagnosis; CS – survival after catheter placement) were recorded. RESULTS: A total of 38 patients, with mean SD age = 58.08 (9.80) years, male = 22 (57.9%), were evaluated. According to Bismuth-Corlette classification, 15 (39.5%) were in stage IIIA, 5 (13.2%) were in stage IIIB, 10 (26.3%) were in stage IV, and 8 (21.2%) were undefined. Of those, 21 (55.3%), 15 (39.5%), and 17 (44.7%) were involved with liver parenchyma, great vessels, and regional lymph nodes, respectively. Mean SD of OS was 15.11 (8.10) months (median = 15; 95% CI: 13.25-16.69), and CS was 2-29 months (mean SD = 11.71 (7.29); median = 10; 95% CI: 10.05-13.37). Further analysis revealed a considerable decrease in OS and CS in those with an involvement of liver parenchyma, great vessels, regional lymph nodes, and Bismuth type IV. CONCLUSIONS: Multimodality therapeutic approach in patients with inoperable ECCs could definitely improve their survival time and decrease complications. Survival time is significantly depending on tumor staging, gender, and involvement of liver parenchyma, great vessels, and regional lymph nodes. |
format | Online Article Text |
id | pubmed-7207240 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Termedia Publishing House |
record_format | MEDLINE/PubMed |
spelling | pubmed-72072402020-05-11 Multimodality treatment in unresectable cholangiocarcinoma Aghili, Mahdi Saberi, Hazhir zadeh, Mahtab Mojtahed Jafari, Fatemeh Mehrabinejad, Mohammad-Mehdi Dashti, Habibollah Saberi, Pejman Yazdi, Niloofar Ayoobi J Contemp Brachytherapy Original Paper PURPOSE: Cholangiocarcinomas (CCs) are rare and highly malignant cancers. Although there are different treatment protocols for treatment of cholangiocarcinoma, we aimed to investigate a survival rate of patients with unresectable extrahepatic CCs (ECCs) receiving multimodality therapeutic protocol (MTP) (biliary drainage + external beam radiotherapy [EBRT] + brachytherapy and systemic chemotherapy). Similarly, we aimed to identify a relationship between survival time and associated factors in treatment outcome. MATERIAL AND METHODS: This retrospective study was performed on patients with ECC, who were referred to our university hospital between 2012 and 2015, and their imaging were diagnosed as unresectable. Patients underwent MTP including internal-external drainage catheter (F10-12) with insertion under fluoroscopy guidance, EBRT with 25-28 fractions and concurrent chemotherapy using capecitabine (Xeloda) 825 mg/m(2) at the days of radiotherapy, followed by brachytherapy (BT) with iridium-192 ((192)Ir) or cobalt-60 ((60)Co) sources for 21 Gy in 3 consecutive days. Demographic variables, complications, laboratory tests, imaging findings, and survival time (OS – overall survival after diagnosis; CS – survival after catheter placement) were recorded. RESULTS: A total of 38 patients, with mean SD age = 58.08 (9.80) years, male = 22 (57.9%), were evaluated. According to Bismuth-Corlette classification, 15 (39.5%) were in stage IIIA, 5 (13.2%) were in stage IIIB, 10 (26.3%) were in stage IV, and 8 (21.2%) were undefined. Of those, 21 (55.3%), 15 (39.5%), and 17 (44.7%) were involved with liver parenchyma, great vessels, and regional lymph nodes, respectively. Mean SD of OS was 15.11 (8.10) months (median = 15; 95% CI: 13.25-16.69), and CS was 2-29 months (mean SD = 11.71 (7.29); median = 10; 95% CI: 10.05-13.37). Further analysis revealed a considerable decrease in OS and CS in those with an involvement of liver parenchyma, great vessels, regional lymph nodes, and Bismuth type IV. CONCLUSIONS: Multimodality therapeutic approach in patients with inoperable ECCs could definitely improve their survival time and decrease complications. Survival time is significantly depending on tumor staging, gender, and involvement of liver parenchyma, great vessels, and regional lymph nodes. Termedia Publishing House 2020-04-30 2020-04 /pmc/articles/PMC7207240/ /pubmed/32395137 http://dx.doi.org/10.5114/jcb.2020.94582 Text en Copyright © 2020 Termedia http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0). License (http://creativecommons.org/licenses/by-nc-sa/4.0/) |
spellingShingle | Original Paper Aghili, Mahdi Saberi, Hazhir zadeh, Mahtab Mojtahed Jafari, Fatemeh Mehrabinejad, Mohammad-Mehdi Dashti, Habibollah Saberi, Pejman Yazdi, Niloofar Ayoobi Multimodality treatment in unresectable cholangiocarcinoma |
title | Multimodality treatment in unresectable cholangiocarcinoma |
title_full | Multimodality treatment in unresectable cholangiocarcinoma |
title_fullStr | Multimodality treatment in unresectable cholangiocarcinoma |
title_full_unstemmed | Multimodality treatment in unresectable cholangiocarcinoma |
title_short | Multimodality treatment in unresectable cholangiocarcinoma |
title_sort | multimodality treatment in unresectable cholangiocarcinoma |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7207240/ https://www.ncbi.nlm.nih.gov/pubmed/32395137 http://dx.doi.org/10.5114/jcb.2020.94582 |
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