Carbon-ion radiotherapy for cholangiocarcinoma

A multi-institutional study by and the Japan carbon-ion radiation oncology study group (J-CROS)

Goro Kasuya, Kazuki Terashima, Kei Shibuya, Shingo Toyama, Daniel K. Ebner, Hiroshi Tsuji, Tomoaki Okimoto, Tatsuya Ohno, Yoshiyuki Shioyama, Takashi Nakano, Tadashi Kamada

Research output: Contribution to journalArticle

Abstract

To evaluate the safety and efficacy of carbon-ion radiotherapy (CIRT) for cholangiocarcinoma via a multicenter retrospective study. Clinical data were collected from patients with cholangiocarcinoma who had received CIRT at one of four treating institutions in Japan. Of 56 eligible patients, none received surgery for cholangiocarcinoma before or after CIRT. The primary endpoint was overall survival (OS). Based on the tumor site, the 56 cases were categorized as intrahepatic cholangiocarcinoma (IHC) (n=27) or perihilar cholangiocarcinoma (PHC) (n=29). In all patients, the median tumor size was 37 (range, 15‒110) mm, and the most commonly prescribed dose was 76 Gy (relative biological effectiveness) in 20 fractions. The median survival was 14.8 (range, 2.1-129.2) months, and the 1- and 2-year OS rates were 69.7% and 40.9%, respectively. The median survival times of the patients with IHC and those with PHC were 23.8 and 12.6 months, respectively. Both univariate and multivariate analyses revealed that cholangitis pre-CIRT and Child‒Pugh class B were significant prognostic factors for an unfavorable OS. Of four patients who died of liver failure, one with IHC was suspected to have radiation-induced liver disease because of newly developed ascites, and died at 4.3 months post-CIRT. Grade 3 CIRT-related bile duct stenosis was observed in one IHC case. No other CIRT-related severe adverse events, including gastrointestinal events, were observed. These results suggest that CIRT yields relatively favorable treatment outcomes, especially for patients with IHC, and acceptable toxicities were observed in patients with cholangiocarcinoma who did not receive surgery.

Original languageEnglish
Pages (from-to)4369-4379
Number of pages11
JournalOncotarget
Volume10
Issue number43
Publication statusPublished - Jul 1 2019

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Heavy Ion Radiotherapy
Radiation Oncology
Cholangiocarcinoma
Japan
Carbon
Ions
Klatskin Tumor
Survival
Relative Biological Effectiveness
Cholangitis
Liver Failure
Bile Ducts
Ascites
Multicenter Studies
Liver Diseases
Neoplasms
Pathologic Constriction
Multivariate Analysis
Survival Rate
Retrospective Studies

All Science Journal Classification (ASJC) codes

  • Oncology

Cite this

Kasuya, G., Terashima, K., Shibuya, K., Toyama, S., Ebner, D. K., Tsuji, H., ... Kamada, T. (2019). Carbon-ion radiotherapy for cholangiocarcinoma: A multi-institutional study by and the Japan carbon-ion radiation oncology study group (J-CROS). Oncotarget, 10(43), 4369-4379.

Carbon-ion radiotherapy for cholangiocarcinoma : A multi-institutional study by and the Japan carbon-ion radiation oncology study group (J-CROS). / Kasuya, Goro; Terashima, Kazuki; Shibuya, Kei; Toyama, Shingo; Ebner, Daniel K.; Tsuji, Hiroshi; Okimoto, Tomoaki; Ohno, Tatsuya; Shioyama, Yoshiyuki; Nakano, Takashi; Kamada, Tadashi.

In: Oncotarget, Vol. 10, No. 43, 01.07.2019, p. 4369-4379.

Research output: Contribution to journalArticle

Kasuya, G, Terashima, K, Shibuya, K, Toyama, S, Ebner, DK, Tsuji, H, Okimoto, T, Ohno, T, Shioyama, Y, Nakano, T & Kamada, T 2019, 'Carbon-ion radiotherapy for cholangiocarcinoma: A multi-institutional study by and the Japan carbon-ion radiation oncology study group (J-CROS)', Oncotarget, vol. 10, no. 43, pp. 4369-4379.
Kasuya, Goro ; Terashima, Kazuki ; Shibuya, Kei ; Toyama, Shingo ; Ebner, Daniel K. ; Tsuji, Hiroshi ; Okimoto, Tomoaki ; Ohno, Tatsuya ; Shioyama, Yoshiyuki ; Nakano, Takashi ; Kamada, Tadashi. / Carbon-ion radiotherapy for cholangiocarcinoma : A multi-institutional study by and the Japan carbon-ion radiation oncology study group (J-CROS). In: Oncotarget. 2019 ; Vol. 10, No. 43. pp. 4369-4379.
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abstract = "To evaluate the safety and efficacy of carbon-ion radiotherapy (CIRT) for cholangiocarcinoma via a multicenter retrospective study. Clinical data were collected from patients with cholangiocarcinoma who had received CIRT at one of four treating institutions in Japan. Of 56 eligible patients, none received surgery for cholangiocarcinoma before or after CIRT. The primary endpoint was overall survival (OS). Based on the tumor site, the 56 cases were categorized as intrahepatic cholangiocarcinoma (IHC) (n=27) or perihilar cholangiocarcinoma (PHC) (n=29). In all patients, the median tumor size was 37 (range, 15‒110) mm, and the most commonly prescribed dose was 76 Gy (relative biological effectiveness) in 20 fractions. The median survival was 14.8 (range, 2.1-129.2) months, and the 1- and 2-year OS rates were 69.7{\%} and 40.9{\%}, respectively. The median survival times of the patients with IHC and those with PHC were 23.8 and 12.6 months, respectively. Both univariate and multivariate analyses revealed that cholangitis pre-CIRT and Child‒Pugh class B were significant prognostic factors for an unfavorable OS. Of four patients who died of liver failure, one with IHC was suspected to have radiation-induced liver disease because of newly developed ascites, and died at 4.3 months post-CIRT. Grade 3 CIRT-related bile duct stenosis was observed in one IHC case. No other CIRT-related severe adverse events, including gastrointestinal events, were observed. These results suggest that CIRT yields relatively favorable treatment outcomes, especially for patients with IHC, and acceptable toxicities were observed in patients with cholangiocarcinoma who did not receive surgery.",
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