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Strahlentherapie und Onkologie
Published in: Strahlentherapie und Onkologie 2/2019

01-02-2019 | Review Article

Efficacy of stereotactic body radiotherapy for unresectable or recurrent cholangiocarcinoma: a meta-analysis and systematic review

Authors: Jeongshim Lee, MD, Won Sup Yoon, MD, PhD, Woong Sub Koom, MD, PhD, Chai Hong Rim, MD

Published in: Strahlentherapie und Onkologie | Issue 2/2019

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Abstract

Purpose

Non-surgical treatment including stereotactic body radiation therapy (SBRT) have been used practically as alternative modalities for unresectable or recurrent cholangiocarcinoma (CC). We performed a systematic review and meta-analysis to examine the efficacy of SBRT for such patients.

Methods

Embase, PubMed, MEDLINE, and Cochrane library databases were searched systematically until October 2017. Primary endpoint was 1‑year local control (LC) rate; 1‑year overall survival (OS), response rates, and grade ≥3 toxicities were assessed as secondary endpoints.

Results

Eleven studies (226 patients) were included. The prescribed median SBRT dose was 45 (range 30–55) Gy in 3–5 fractions. The pooled 1‑year LC rate was 81.8% (95% confidence interval [CI] 69.4–89.9%) in the studies using an equivalent dose in 2 Gy per fraction (EQD2) ≥71.3 Gy2 and 74.7% (95% CI 57.1–86.7%) in the studies using an EQD2 <71.3 Gy2. The median OS was 13.6 (range 10–35.5) months. The pooled 1‑year OS rate was 53.8% (95% CI 44.9–62.5%) and the pooled 1‑year LC rate was 78.6% (95% CI 69.0–85.8%). Most common toxicity was duodenal ulcer and gastric ulcer in available studies, with the acute incidence of grade ≥3 of less than 10% and the late incidence of 10–20%.

Conclusions

SBRT was a feasible treatment option with respect to achieving a high LC for unresectable or recurrent CC. Gastrointestinal toxicity is acceptable, but remains an obstacle related to dose escalation.
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Metadata
Title
Efficacy of stereotactic body radiotherapy for unresectable or recurrent cholangiocarcinoma: a meta-analysis and systematic review
Authors
Jeongshim Lee, MD
Won Sup Yoon, MD, PhD
Woong Sub Koom, MD, PhD
Chai Hong Rim, MD
Publication date
01-02-2019
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 2/2019
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-018-1367-2

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