Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Nov 28;14(23):5864.
doi: 10.3390/cancers14235864.

Particle Beam Therapy for Intrahepatic and Extrahepatic Biliary Duct Carcinoma: A Multi-Institutional Retrospective Data Analysis

Hideya Yamazaki  1 , Takuya Kimoto  1 , Motohisa Suzuki  2 , Masao Murakami  2 , Osamu Suzuki  3 , Masaru Takagi  4 , Norio Katoh  5 , Takeshi Arimura  6 , Takashi Ogino  6 , Hiroyuki Ogino  7
Affiliations

Particle Beam Therapy for Intrahepatic and Extrahepatic Biliary Duct Carcinoma: A Multi-Institutional Retrospective Data Analysis

Hideya Yamazaki et al. Cancers (Basel). .

Abstract

To examine the efficacy and toxicity of particle beam therapy (PT) for biliary duct carcinoma (BDC) and compare the outcomes between extrahepatic BDC (eBDC) and intrahepatic BDC (iBDC). We analyzed multi-institutional data from May 2009 to December 2019. The primary endpoint was overall survival (OS), and the secondary endpoints were local control (LC), progression-free survival (PFS) and toxicity. We included 150 patients with unresectable BDC treated with PT using a median prescribed dose of 70.2 GyRBE (range, 44-77 GyRBE) in 25 fractions (range, 10-38 fractions). With a median follow-up of 13.0 months, median survival time (MST) was 21 months, and 2-year OS was 44.8%. For eBDC and iBDC, the MSTs were 20 and 23 months, respectively. Two-year PFS and LC rates were 20.6% and 66.5%, respectively. Vascular invasion, prescribed dose and serum tumor marker level (carcinoembryonic antigen: CEA) were identified as poor prognostic factors for OS. A higher radiation dose EQD2 ≥ 67 Gy showed superior OS, with a hazard ratio of 0.341. The radiation dose of PT is an important predisposing factor for overall survival. The MST for patients with eBDC given a higher radiation dose was 25 months, compared to 15 months for those given the lower dose and 23 months for patients with iBDC (all iBDC given higher doses). iBDC and eBDC duct carcinomas showed equivalent outcomes with PT, especially when treated with a high radiation dose. In detailed analysis, baseline CEA level in iBDC, and radiation dose and GTV in eBDC were statistically significant predicators for OS. Acute and late toxicity grade ≥3 occurred in 2.2% and 2.7% of patients, respectively, including two late grade-5 toxicities. In conclusion, PT showed good efficacy for BDC, both eBDC and iBDC, with a low incidence of severe toxicity.

Keywords: biliary duct carcinoma; extrahepatic bile duct carcinoma; intrahepatic duct carcinoma; particle beam therapy.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Overall survival rate (OS), progression-free survival rate (PFS) and local control (LC). (A) Overall survival rate (OS), progression free survival rate (PFS) and local control rate (LC). (B) OS between extrahepatic biliary duct carcinoma (eBDC) and intrahepatic biliary duct carcinoma (iBDC). (C) OS according to primary location.
Figure 2
Figure 2
Influential factors for overall survival rate. (A) OS according to Vascular invasion. (B) OS according to pretreatment CEA level. (C) OS according to radiation dose. (D) OS according to radiation dose and primary location of tumor.
Figure 2
Figure 2
Influential factors for overall survival rate. (A) OS according to Vascular invasion. (B) OS according to pretreatment CEA level. (C) OS according to radiation dose. (D) OS according to radiation dose and primary location of tumor.
Figure 3
Figure 3
Influential factors for overall survival rate. (A) OS according to GTV in eBDC. (B) OS according to radiation dose in eBDC.
Figure 4
Figure 4
Influential factor for overall survival rate in iBDC. (A) OS according to baseline CEA level in iBDC.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Valle J.W., Kelley R.K., Nervi B., Oh D.Y., Zhu A.X. Biliary tract cancer. Lancet. 2021;397:428–444. doi: 10.1016/S0140-6736(21)00153-7. - DOI - PubMed
    1. Ouyang G., Liu Q., Wu Y., Liu Z., Lu W., Li S., Pan G., Chen X. The global, regional and national burden of the gallbladder and biliary duct carcinoma and its attributable risk factors in 195 countries and territories, 1990 to 2017: A systematic analysis for the Global Burden of Disease Study 2017. Cancer. 2021;127:2238–2250. doi: 10.1002/cncr.33476. - DOI - PubMed
    1. Jarnagin W.R., Shoup M. Surgical management of cholangiocarcinoma. Semin. Liver Dis. 2004;24:189–199. doi: 10.1055/s-2004-828895. - DOI - PubMed
    1. Esnaola N.F., Meyer J.E., Karachristos A., Maranki J.L., Camp E.R., Denlinger C.S. Evaluation and management of intrahepatic and extrahepatic cholangiocarcinoma. Cancer. 2016;122:1349–1369. doi: 10.1002/cncr.29692. - DOI - PubMed
    1. Keane F.K., Zhu A.X., Hong T.S. Radiotherapy for Biliary Tract Cancers. Semin. Radiat. Oncol. 2018;28:342–350. doi: 10.1016/j.semradonc.2018.06.003. - DOI - PubMed

LinkOut - more resources