Evaluation of chemoradiotherapy for local recurrence after the resection of biliary tract cancer

Abstract

This retrospective study investigated the outcomes of chemoradiotherapy (CRT) for local recurrence of biliary tract cancer (BTC) after surgery. Thirteen patients with isolated local recurrence of BTC received CRT in our hospital. Primary cancer lesions were intrahepatic bile duct (n=1), extrahepatic bile duct (n=9), gallbladder (n=2) and ampulla of Vater (n=1). The dominant recurrence sites were in resected margin of bile duct (n=7), tissues around the hepatoduodenal ligament (n=5) and lymph nodes (n=3). External radiotherapy was delivered in ten 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. Although twelve patients were completed the scheduled CRT, adverse effects in Grade 2 or 3 was observed in six patients. Local progression occurred in four patients. The median of progression free survival time was 9.7 months. The 1 and 2-year overall survival rates after the CRT was 38% and 19%. 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.