TY - JOUR
T1 - Image-guided intensity-modulated radiotherapy (IG-IMRT) for biliary adenocarcinomas
T2 - Initial clinical results
AU - Fuller, Clifton David
AU - Dang, Nguyen Dinh
AU - Wang, Samuel J.
AU - Desai, Prashant
AU - Choi, Mehee
AU - Thomas, Charles R.
AU - Fuss, Martin
N1 - Funding Information:
C.D.F. is supported by a grant from the National Institutes of Health/National Institute of Biomedical Imaging and Bioengineering, “Multidisciplinary Training Program in Human Imaging” (5T32EB000817-04); this funder had no role in study design, in the collection, analysis and interpretation of data, in the writing of the manuscript, nor in the decision to submit the manuscript for publication. Preliminary aspects of these data were presented at the 48th Annual Meeting of the American Society for Therapeutic Radiology and Oncology, November 5–9, 2006. Special thanks are given to Bill Salter, PhD, Adrian Wong, MD, and Garrett Starling, MD for their assistance in data collection.
PY - 2009/8
Y1 - 2009/8
N2 - Purpose: Biliary tract lesions are comparatively rare neoplasms, with ambiguous indications for radiotherapy. The specific aim of this study was to report the clinical results of a single-institution biliary tract series treated with modern radiotherapeutic techniques, and detail results using both conventional and image-guided intensity-modulated radiation therapy (IG-IMRT). Methods and materials: From 2001 to 2005, 24 patients with primary adenocarcinoma of the biliary tract (gallbladder and extrahepatic bile ducts) were treated by IG-IMRT. To compare outcomes, data from a sequential series of 24 patients treated between 1995 and 2005 with conventional radiotherapy (CRT) techniques were collected as a comparator set. Demographic and treatment parameters were collected. Endpoints analyzed included treatment-related acute toxicity and survival. Results: Median estimated survival for all patients completing treatment was 13.9 months. A statistically significant higher mean dose was given to patients receiving IG-IMRT compared to CRT, 59 vs. 48 Gy. IG-IMRT and CRT cohorts had a median survival of 17.6 and 9.0 months, respectively. Surgical resection was associated with improved survival. Two patients (4%) experienced an RTOG acute toxicity score > 2. The most commonly reported GI toxicities (≥RTOG Grade 2) were nausea or diarrhea requiring oral medication, experienced by 46% of patients. Conclusion: This series presents the first clinical outcomes of biliary tract cancers treated with IG-IMRT. In comparison to a cohort of patients treated by conventional radiation techniques, IG-IMRT was feasible for biliary tract tumors, warranting further investigation in prospective clinical trials.
AB - Purpose: Biliary tract lesions are comparatively rare neoplasms, with ambiguous indications for radiotherapy. The specific aim of this study was to report the clinical results of a single-institution biliary tract series treated with modern radiotherapeutic techniques, and detail results using both conventional and image-guided intensity-modulated radiation therapy (IG-IMRT). Methods and materials: From 2001 to 2005, 24 patients with primary adenocarcinoma of the biliary tract (gallbladder and extrahepatic bile ducts) were treated by IG-IMRT. To compare outcomes, data from a sequential series of 24 patients treated between 1995 and 2005 with conventional radiotherapy (CRT) techniques were collected as a comparator set. Demographic and treatment parameters were collected. Endpoints analyzed included treatment-related acute toxicity and survival. Results: Median estimated survival for all patients completing treatment was 13.9 months. A statistically significant higher mean dose was given to patients receiving IG-IMRT compared to CRT, 59 vs. 48 Gy. IG-IMRT and CRT cohorts had a median survival of 17.6 and 9.0 months, respectively. Surgical resection was associated with improved survival. Two patients (4%) experienced an RTOG acute toxicity score > 2. The most commonly reported GI toxicities (≥RTOG Grade 2) were nausea or diarrhea requiring oral medication, experienced by 46% of patients. Conclusion: This series presents the first clinical outcomes of biliary tract cancers treated with IG-IMRT. In comparison to a cohort of patients treated by conventional radiation techniques, IG-IMRT was feasible for biliary tract tumors, warranting further investigation in prospective clinical trials.
KW - Biliary tract cancer
KW - Cholangiocarcinoma
KW - Gallbladder cancer
KW - Image-guided radiotherapy (IGRT)
KW - Intensity-modulated radiation therapy (IMRT)
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U2 - 10.1016/j.radonc.2009.02.015
DO - 10.1016/j.radonc.2009.02.015
M3 - Article
C2 - 19324442
AN - SCOPUS:67650970454
SN - 0167-8140
VL - 92
SP - 249
EP - 254
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
IS - 2
ER -