1. Benchmarking Outcomes after Ablative Radiotherapy for Molecularly Characterized Intrahepatic Cholangiocarcinoma.
- Author
-
De, Brian, Abu-Gheida, Ibrahim, Patel, Aashini, Ng, Sylvia S. W., Zaid, Mohamed, Thunshelle, Connor P., Elganainy, Dalia, Corrigan, Kelsey L., Rooney, Michael K., Javle, Milind, Raghav, Kanwal, Lee, Sunyoung S., Vauthey, Jean-Nicolas, Tzeng, Ching-Wei D., Tran Cao, Hop S., Ludmir, Ethan B., Minsky, Bruce D., Smith, Grace L., Holliday, Emma B., and Taniguchi, Cullen M.
- Subjects
- *
PROGRESSION-free survival , *CHOLANGIOCARCINOMA , *PORTAL vein , *PROGNOSIS , *NUCLEOTIDE sequencing , *RADIOTHERAPY - Abstract
We have previously shown that ablative radiotherapy (A-RT) with a biologically effective dose (BED10) ≥ 80.5 Gy for patients with unresectable intrahepatic cholangiocarcinoma (ICC) is associated with longer survival. Despite recent large-scale sequencing efforts in ICC, outcomes following RT based on genetic alterations have not been described. We reviewed records of 156 consecutive patients treated with A-RT for unresectable ICC from 2008 to 2020. For 114 patients (73%), next-generation sequencing provided molecular profiles. The overall survival (OS), local control (LC), and distant metastasis-free survival (DMFS) were estimated using the Kaplan–Meier method. Univariate and multivariable Cox analyses were used to determine the associations with the outcomes. The median tumor size was 7.3 (range: 2.2–18.2) cm. The portal vein thrombus (PVT) was present in 10%. The RT median BED10 was 98 Gy (range: 81–144 Gy). The median (95% confidence interval) follow-up was 58 (42–104) months from diagnosis and 39 (33–74) months from RT. The median OS was 32 (29–35) months after diagnosis and 20 (16–24) months after RT. The one-year OS, LC, and intrahepatic DMFS were 73% (65–80%), 81% (73–87%), and 34% (26–42%). The most common mutations were in IDH1 (25%), TP53 (22%), ARID1A (19%), and FGFR2 (13%). Upon multivariable analysis, the factors associated with death included worse performance status, larger tumor, metastatic disease, higher CA 19-9, PVT, satellitosis, and IDH1 and PIK3CA mutations. TP53 mutation was associated with local failure. Further investigation into the prognostic value of individual mutations and combinations thereof is warranted. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF