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1、Characterization of unresectable cholangiocarcinoma patients treated with or without chemoradiationAuthor(s): Jane Elizabeth Rogers Department of Pharmacy Clinical Programs, The University of Texas MD Anderson Cancer Center, Houston, TXJ Clin Oncol 33, 2015 (suppl 3; abstr 403)Reporter DR pengying1B
2、ackgroundCurative treatment for CC is surgical resection. Unfortunately, most CC patients (pts) present with unresectable disease in which gemcitabine plus platinum (GEM-P) chemotherapy is the mainstay of treatment (tx). Advanced CC has a dismal prognosis with 5-year survival reported at 5-10 %. Dat
3、a regarding chemoradiation (CRT) in pts with unresectable CC (uCC) remains limited. 2IntroductionBiliary tract cancers,including cholangiocarcinoma (CC) and gallbladder cancers, are rare with limited data ragarding treatment. Most patients present with unresectable CC resulting in a poor prognosis.C
4、RT is the mainstay of treatment for uCC.There is limited data regarding localized therapy with CRT.3MethodsWe retrospectively reviewed uCC pts from 1/1/2009 to 7/31/2013. Primary objective: Determine the percentage of pts treated with CRTEvaluate the median number of chemotherapy cycles given prior
5、to CRT 4Secondary objectives: Disease response to first-line txDuration of CRT controlProgression-free survival (PFS) with or without CRToverall survival (OS) with or without CRT5Inclusion criteria: uCC diagnosis, received tx, and had follow-up at our institution. Exclusion criteria: pts who receive
6、d liver-directed therapy other than CRT, mixed histology tumors, and a history of other malignancies.6Results114 pts were included with 62% having intrahepatic CC. Median age: 63 Gender: females (53.5%); male (46.5%).Site of disease: intra (62%), Hilar (24%), Extra (14%) .765% of pts received CRT(7%
7、 radiation alone) with a median of 6(range 0-26) chemotherapy cycles given prior to CRT.66% received gemcitabine + platinum (cisplatin/oxaliplain) as ffirst-line treatment.8Disease control (DC) (response + stable disease) with first-line tx was 75% with 71% receiving GEM-P +/- erlotinib first-line.
8、9DC after CRT was 62% with a median duration of radiation control of 6.4 mths. Median PFS and OS for all pts were 13.4 mths and 27.8 mths, respectively. 10Median PFS in the CRT group was 14.5 mths versus 11.4 mths in the no CRT group (p = 0.105). Median OS in the CRT cohort was 29.4 mths, while medi
9、an OS without CRT was 22.4 mths (p = 0.005). 11Median OS and PFS after CRT for pts with DC on first-line tx were 32.0 months (95% CI = 24-44 mths) and 15.7 mths (95% CI =13.5-18.8 mths), respectively. Pts who progressed on first-line tx and received CRT had a median OS of 23.8 mths (95% CI = 7-30 mo
10、nths) and median PFS of 4.2 mths (95% CI = 2.3-9 mths).121314ConclusionsOur retrospective review reveals a significant improvement in median OS with CRT in uCC pts. Those with DC on first-line tx showed improvement in PFS and OS with CRT. Patient selection is key with the benefit being highest in pts with DC with first-line tx. Our results warrant further investigation of the role of CRT in uCC.15References1617
