https://openworks.mdanderson.org/sumexp21/1005/thumbnail.jp

Abi Jaoude, Joseph, MD

Koay, Eugene J., MD, PhD

Ludmir, Ethan B., MD

Nieves-Jimenez, Humberto R.

Taniguchi, Cullen M., MD, PhD

English

OpenWorks @ MD Anderson

The Role of Radiotherapy In the Management of Massive Intrahepatic CholangiocarcinomaHumberto R. Nieves-Jimenez, BS1;2; Joseph Abi Jaoude, MD1; Eugene J. Koay, MD, PhD1; Ethan B. Ludmir, MD1; Cullen M. Taniguchi, MD, PhD11The University of Texas MD Anderson Cancer Center, Houston, TX2Universidad Central del Caribe School of Medicine, Bayamon, Puerto RicoMethods • We performed a retrospective review of patients with IHCC treated with RT at The University of Texas MD Anderson Cancer Center. • Patients with a gross tumor volume (GTV) of 800cc or more were eligible for inclusion. • The main outcomes were overall survival (OS), local progression- (LPFS), and distant metastasis- free survival (DMFS) from the beginning of RT. • Treatment toxicity was assessed by regularly documented CTCAE criteria.Results• GTV/Liver Volume : 43.9% (31.1-61.8).• The median GTV was 1277.7cc (IQR 900.0-1929.4).• Only 2 patients (16.7%) died from tumor-related liver failure.• The main adverse events noted were grade 1 fatigue (9, 75.0%), nausea (6, 50.0%) and abdominal pain (6, 50.0%).Conclusions• Patients with large IHCC showed excellent clinical outcomes in response to high dose RT, within minimal toxicity. • Future prospective studies are needed to better define the role of RT and possibly systemic treatments in this patient population. Background• Intrahepatic cholangiocarcinoma (IHCC) often presents as large tumors with limited role for local therapy.• Higher radiation therapy (RT) doses may improve outcomes in this patient population. • We present our experience with RT treatment in patients with large IHCC.Table 1: Patient and Tumor Characteristics N=12Age 60.0 (55.0-66.8)SexFemale 4 (33.3)Male 8 (66.7)T Stage 2 7 (58.3)3 4 (33.3)4 1 (8.3)N Stage 0 5 (41.7)1 7 (58.3)M Stage0 8 (66.7)1 4 (33.3)Table 2: Treatment CharacteristicsN=12Chemotherapy pre-RTYes 11 (91.7)No 1 (8.3)RT TechniqueIMRT 8 (66.7)Proton 4 (33.3)RT Dose 67.5 (60-73.1)RT fractions 15 (15-15)Concurrent ChemoRTYes 9 (75.0)No 3 (25.0)Chemotherapy post-RTYes 7 (58.3)No 5 (41.7)Median: 20 months Median: 20 monthsMedian: 7.4 months Median: 11.3 monthsFigure 1. Figure 2.Figure 3. Figure 4.Figure 5. Axial view of patient liver with tumor of a GTV of 2010.6cc.Isodoses (cGy)§ 6750§ 6400§ 6000§ 5000§ 4500§ 4000§ 3750§ 3000§ 2000§ 1000§ 500

The Role of Radiotherapy In the Management of Massive Intrahepatic Cholangiocarcinoma

https://openworks.mdanderson.org/cgi/viewcontent.cgi?article=1005&context=sumexp21

The Role of Radiotherapy In the Management of Massive Intrahepatic Cholangiocarcinoma

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