Benchmarking Outcomes after Ablative Radiotherapy for Molecularly Characterized Intrahepatic Cholangiocarcinoma

Journal of Personalized Medicine

Milind Javle¹  Sunyoung S. Lee¹  Kanwal Raghav¹  Ibrahim Abu-Gheida²  Ethan B. Ludmir²  Prajnan Das²  Kelsey L. Corrigan²  Aashini Patel²  Brian De²  Albert C. Koong²  Mohamed Zaid²  Bruce D. Minsky²  Grace L. Smith²  Eugene J. Koay²  Dalia Elganainy²  Emma B. Holliday²  Sylvia S. W. Ng²  Cullen M. Taniguchi²  Connor P. Thunshelle²  Michael K. Rooney²  Jean-Nicolas Vauthey³  Ching-Wei D. Tzeng³  Hop S. Tran Cao³ 

[1] Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;

关键词: cholangiocarcinoma;    mutation;    genetic;    genomic;    radiotherapy;   

DOI  :  10.3390/jpm11121270

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown