ReviewWorld journal of gastrointestinal pharmacology and therapeutics2025
Evolving role of radiation therapy in advanced/metastatic intrahepatic cholangiocarcinoma.
Review in World journal of gastrointestinal pharmacology and therapeutics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
This review evaluates the role of stereotactic body radiation therapy (SBRT) in advanced/metastatic intrahepatic cholangiocarcinoma (iCCA), highlighting its efficacy, integration with systemic therapy, and potential for resection or transplantation. SBRT is emerging as a transformative, non-invasive treatment for iCCA, extending beyond palliation. SBRT with a biologically effective dose > 75 Gy improves survival in unresectable iCCA, with median overall survival (mOS) of 15-24 months, significantly surpassing lower-dose regimens. Advanced motion management techniques like fiducial tracking and gating achieve > 70% local control at 1 year. In metastatic iCCA, hypo-fractionated SBRT provides symptom relief with mOS of 6-9 months and reduced toxicity. Neoadjuvant SBRT increases R0 resection rates to 60%-75% in borderline resectable cases, compared to 30%-40% with chemotherapy alone. SBRT combined with systemic therapy expands eligibility for liver transplantation, achieving 3-year post-transplant survival > 65%. SBRT is a transformative therapy for iCCA, improving control, survival, and eligibility for curative treatments. Further research is needed to optimize protocols and patient selection.
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