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Proton beam therapy for unresectable intrahepatic cholangiocarcinoma.
[cholangiocarcinoma]
Treatment
for
unresectable
intrahepatic
cholangiocarcinoma
(
ICC
)
has
not
been
established
.
The
aim
of
the
study
was
to
evaluate
the
outcome
of
proton
beam
therapy
(
PBT
)
for
patients
with
unresectable
ICC
.
Up
to
2010
,
20
patients
(
11
males
,
9
females
,
median
age
63
y
.
o
.
)
with
unresectable
ICC
(
2
,
7
,
7
and
4
in
stages
II
,
IIIA
,
IIIC
and
IV
,
respectively
)
were
treated
with
PBT
.
The
largest
dimensions
of
the
tumors
ranged
from
15
to
140
mm
(
median
:
50
mm
)
.
The
intrahepatic
region
and
lymph
nodes
received
median
total
proton
doses
of
72
.
6
GyE
in
22
fractions
and
56
.
1
GyE
in
17
fractions
,
respectively
.
Four
patients
received
concurrent
chemotherapy
(
tegafur
,
gimeracil
and
oteracil
;
TS
-
1
)
during
PBT
.
Twelve
patients
were
treated
curatively
and
8
were
treated
palliatively
because
tumors
were
present
outside
the
irradiation
field
.
In
the
curative
group
,
9
tumors
within
the
irradiated
field
were
controlled
in
follow-up
of
8
.
6
-
62
.
6
months
(
median
:
20
.
8
months
)
.
Median
survival
rates
in
the
curative
and
palliative
groups
were
27
.
5
and
9
.
6
months
,
respectively
,
and
overall
1
-
and
3
-
year
survival
rates
were
82
%
and
38
%
,
and
50
%
and
0
%
,
respectively
.
Eight
patients
survived
for
>
2
years
and
there
was
no
distant
metastasis
in
5
of
these
patients
after
2
years
.
No
severe
side
effects
occurred
.
The
results
suggest
that
long
-term
survival
can
be
achieved
using
PBT
for
patients
with
unresectable
ICC
without
distant
metastasis
.
Further
studies
are
required
to
determine
the
optimal
treatment
schedule
and
best
combination
of
PBT
and
chemotherapy
.
Diseases
Validation
Diseases presenting
"long-term survival"
symptom
alexander disease
carcinoma of the gallbladder
cholangiocarcinoma
epidermolysis bullosa simplex
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
malignant atrophic papulosis
megacystis-microcolon-intestinal hypoperistalsis syndrome
omenn syndrome
severe combined immunodeficiency
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