演題抄録

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開催概要
開催回
第56回・2018年・横浜
 

胆道癌術後再発に対するサルベージ化学放射線治療の効果

演題番号 : O36-6

[筆頭演者]
演者)前村 公成:1 
[共同演者]
又木 雄弘:1、蔵原 弘:1、川崎 洋太:1、田上 聖徳:1、橋口 真征:1、飯野 聡:1、迫田 雅彦:1、上野 真一:2、新地 洋之:2,3、夏越 祥次:1

1:鹿児島大学・消化器乳腺甲状腺外科、2:鹿児島大学・臨床腫瘍学、3:鹿児島大学・保健学科

 

Backgournd: The role of multidicipinally treatment including radiotherapy for recurrence after the surgery of biliary tract cancer (BTC). This retrospective study investigated the outcome of salvage chemoradiotherapy (CRT) for locoregionally recurrent of BTC after surgery.
Patients: Eighteen patients with isolated recurrence of BTC received CRT in our hospital. Mean age of the patients was 67 years old and thirteen patients are male. Primary cancer lesions were intrahepatic bile duct (n=1), extrahepatic bile duct (n=12), gallbladder (n=4) and ampulla of Vater (n=1). The dominant recurrence sites were in resected margin of bile duct (n=8), tissues around the hepatoduodenal ligament (n=9) and lymph nodes including (n=2). External radiotherapy was delivered in all patients and intra-ductal irradiation using 192I in three patients. 5-Fu, Gemcitabine or S-1 was administered as concomitant chemotherapy. We analyzed the adverse effect, local response and survival time after the therapy.
Results: Although seventeen patients were completed the scheduled CRT, adverse effects in Grade 2 or 3 was observed in seven patients. Local progression occurred in eight patients after CRT. The median of overall survival time (MST) after the treatment for recurrence was 14.7 months. The 1 and 2-year overall survival rates after the CRT was 45% and 32%. The patients who achieved partial response of stable disease had 20.9 months of MST. The MST of patients with ductal margin recurrence had significantly longer than that of patients with other recurrence pattern, 21 months and 4.7 months respectively. We performed surgical resection of the recurrent lesion in three patients who were controlled the disease after CRT.
Conclusion: The suppression of local growth after CRT was favorable prognostic factor for overall survival after the treatment. The CRT for local recurrence of BTC was feasible and safe with contribution in prolong of survival by local disease control.

キーワード

臓器別:胆嚢・胆道

手法別:放射線治療

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