Adjuvant concurrent chemoradiation therapy (CCRT) alone versus CCRT followed by adjuvant chemotherapy: Which is better in patients with radically resected extrahepatic biliary tract cancer?: a non-randomized, single center study

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• 作者：Kyu-Hyoung Lim (1)
  Do-Youn Oh (1) (4)
  Eui Kyu Chie (2)
  Jin-Young Jang (3)
  Seock-Ah Im (1) (4)
  Tae-You Kim (1) (4)
  Sun-Whe Kim (3)
  Sung Whan Ha (2)
  Yung-Jue Bang (1) (4)
  
• 刊名：BMC Cancer
• 出版年：2009
• 出版时间：December 2009
• 年：2009
• 卷：9
• 期：1
• 全文大小：883KB
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• 作者单位：Kyu-Hyoung Lim (1)
  Do-Youn Oh (1) (4)
  Eui Kyu Chie (2)
  Jin-Young Jang (3)
  Seock-Ah Im (1) (4)
  Tae-You Kim (1) (4)
  Sun-Whe Kim (3)
  Sung Whan Ha (2)
  Yung-Jue Bang (1) (4)
  
  1. Departments of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
  4. Cancer Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
  2. Departments of Radiation Oncology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
  3. Departments of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
  
• ISSN：1471-2407

文摘

Background There is currently no standard adjuvant therapy for patients with curatively resected extrahepatic biliary tract cancer (EHBTC). The aim of this study was to analyze the clinical features and outcomes between patients undergoing adjuvant concurrent chemoradiation therapy (CCRT) alone and those undergoing CCRT followed by adjuvant chemotherapy after curative resection. Methods We included 120 patients with EHBTC who underwent radical resection and then received adjuvant CCRT with or without further adjuvant chemotherapy between 2000 and 2006 at Seoul National University Hospital. Results Out of 120 patients, 30 received CCRT alone, and 90 received CCRT followed by adjuvant chemotherapy. Baseline characteristics were comparable between the two groups. Three-year disease-free survival (DFS) rates for CCRT alone and CCRT followed by adjuvant chemotherapy were 26.6% and 45.2% (p = 0.04), respectively, and 3-year overall survival (OS) rates were 30.8% and 62.6% (p < 0.01), respectively. CCRT followed by adjuvant chemotherapy showed longer survival than did CCRT alone, especially in R1 resection (microscopically positive margins) or negative lymph node. Conclusion Adjuvant CCRT followed by adjuvant chemotherapy prolonged DFS and OS, compared with CCRT alone in patients with curatively resected EHBTC. Adjuvant chemotherapy deserves to consider after adjuvant CCRT. In the future, a randomized prospective study will be needed, with the objective of investigating the role of adjuvant chemotherapy.