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Salvage Radiation Therapy for Isolated Local Recurrence of Extrahepatic Cholangiocarcinoma After Radical Surgery: A Retrospective Study.
[cholangiocarcinoma]
This
study
investigated
the
outcomes
of
salvage
radiation
therapy
(
RT
)
for
isolated
local
recurrence
of
extrahepatic
cholangiocarcinoma
(
EHCC
)
after
radical
surgery
.
Between
May
2003
and
July
2011
,
25
patients
with
isolated
recurrence
of
EHCC
received
RT
with
the
aim
of
salvage
.
The
most
common
primary
cancer
was
common
bile
duct
cancer
(
n
=
15
)
followed
by
hilar
cholangiocarcinoma
(
n
=
7
)
and
pancreaticobiliary
type
of
ampulla
of
Vater
cancer
(
n
=
3
)
.
The
median
disease-free
interval
from
initial
operation
to
recurrence
was
12
months
.
The
criteria
for
diagnosis
of
recurrence
were
based
on
radiographic
findings
with
either
computed
tomography
or
positron
emission
tomography
.
The
radiation
dose
ranged
from
40
to
54
Gy
(
median
54
Gy
)
,
and
concurrent
chemotherapy
was
administered
to
19
patients
.
The
median
follow-up
period
was
16
months
.
Local
progression
occurred
in
nine
patients
(
36
%
)
.
The
2
-
year
local
failure
-free
survival
rate
was
44
%
during
a
median
follow-up
period
of
14
months
.
The
2
-
year
overall
survival
rate
was
55
%
during
a
median
follow-up
period
of
24
months
.
A
normal
level
of
CA
19
-
9
at
recurrence
and
concurrent
chemotherapy
were
favorable
prognostic
factors
for
both
local
control
and
overall
survival
.
Distant
metastasis
developed
in
11
patients
,
and
the
liver
was
the
most
common
site
(
n
=
7
)
of
distant
metastasis
.
No
severe
radiation-induced
gastrointestinal
toxicities
developed
.
Salvage
RT
with
or
without
concurrent
chemotherapy
resulted
in
a
median
survival
of
24
months
for
patients
with
isolated
local
recurrence
of
EHCC
.
The
treatment
was
feasible
and
safe
with
minimal
toxicities
.
