ArticleCancer medicine2018
Dose escalation of radiotherapy in unresectable extrahepatic cholangiocarcinoma.
Article in Cancer medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Particle beam therapy versus photon radiotherapy for extrahepatic biliary cancer-systemic review and meta-analysis.Journal of radiation research · 2023Pooled it
- Efficacy of fluoxetine for anorexia nervosa caused by chemotherapy in patients with cholangiocarcinoma.Medicine · 2019Pooled it
- Tumor-related local complications as a major contributor to mortality after definitive radiotherapy for unresectable extrahepatic bile duct cancer.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Article
- Proton beam therapy for patients with distal cholangiocarcinoma: a multicenter prospective registry study (Influence of age factor).Journal of radiation research · 2026Article
- Updated Japanese multicenter registry study evaluates the efficacy and safety of proton beam therapy for treating extrahepatic cholangiocarcinoma.Scientific reports · 2025Article
- Role and Effectiveness of Hypofractionated Proton Beam Therapy and Combinations with Systemic Chemotherapy in Inoperable Extrahepatic Cholangiocarcinoma.Cancer research and treatment · 2025Article
- Clinical outcomes and risk stratification in unresectable biliary tract cancers undergoing radiation therapy.Radiation oncology (London, England) · 2024Article
- Survival and Toxicity in Patients With Unresectable or Inoperable Biliary Tract Cancers With Ablative Radiation Therapy Versus Nonablative Chemoradiation.Advances in radiation oncology · 2024Article
- Molecular profiling and treatment pattern differences between intrahepatic and extrahepatic cholangiocarcinoma.Journal of the National Cancer Institute · 2023Article
- Proton beam therapy for extrahepatic biliary tract cancer: Analysis with prospective multi-institutional patients' registration database, Proton-Net.Clinical and translational radiation oncology · 2023Article
- Hepatic arterial infusion chemotherapy with or without lenvatinib for unresectable cholangiocarcinoma: a single-center retrospective study.Hepatic oncology · 2023Article
- Hepatic arterial infusion chemotherapy plus lenvatinib with or without programmed cell death protein-1 inhibitors for advanced cholangiocarcinoma.Frontiers in immunology · 2023Article
- Article
- Comparison of Hepatic Arterial Infusion Pump Chemotherapy vs Resection for Patients With Multifocal Intrahepatic Cholangiocarcinoma.JAMA surgery · 2022Article
- Clinical outcomes for hilar and extrahepatic cholangiocarcinoma with adjuvant, definitive, or liver transplant-based neoadjuvant chemoradiotherapy strategies: a single-center experience.Journal of gastrointestinal oncology · 2022Article
- Non-surgical treatment of hilar cholangiocarcinoma.World journal of gastrointestinal oncology · 2021Review
- Article
- Chemoradiotherapy for patients with locally advanced or unresectable extra-hepatic biliary cancer.Journal of gastrointestinal oncology · 2020Article
- Radiation dose escalation for locally advanced unresectable intrahepatic and extrahepatic cholangiocarcinoma.Chinese clinical oncology · 2020Review
- The Evolving Role of Radiation Therapy in the Treatment of Biliary Tract Cancer.Frontiers in oncology · 2020Review
Corrections and comments
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Authors and funding
18 authors at 2 institutions in 1 country.
Funding
Abstract
purposeTo evaluate the effect of escalated dose radiation therapy (EDR, defined as doses >50.4 Gy in 28 fractions [59.5 Gy BED]) on overall survival (OS), freedom from local progression (FFLP), and freedom from distant progression (FFDP) of patients with unresectable extrahepatic cholangiocarcinoma (EHCC).
methodsA consecutive cohort of 80 patients who underwent radiotherapy for unresectable EHCC from 2001 to 2015 was identified. Demographic, tumor, treatment, toxicity, and laboratory variables were collected. The maximal RT doses ranged from 30 to 75 Gy (median 50.4 Gy, at 1.8-4.5 Gy/fraction). Gross tumor volume (GTV) coverage by maximal dose in EDR group ranged from 38% to 100%. Kaplan-Meier method was used to estimate OS, FFLP, and FFDP. Univariate and multivariate Cox regression models were analyzed.
resultsAfter radiotherapy, median OS, FFLP, and FFDP were 18.7, 22.6, and 24.3 months, respectively. There was no significant difference in OS or FFLP between patients who received EDR to portions of the GTV and patients who did not. On multivariate analysis, bigger GTV, age, and ECOG performance status were independently associated with shorter OS. Local progression on chemotherapy prior to RT was independently associated with shorter FFLP. High baseline neutrophil/lymphocyte ratio (>5.3) was independently associated with shorter FFDP. Toxicity grades were similar in EDR and lower doses except lymphopenia which was higher in EDR (P = 0.053).
conclusionsEDR to selective portions of the GTV may not benefit patients with unresectable EHCC despite having acceptable toxicity. New methods to improve local control and survival for unresectable EHCC are needed.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.