Abstract
BackgroundThe patterns of radiotherapy (RT) practice for biliary tract cancer (BTC) in Japan are not clearly established.MethodsA questionnaire-based national survey of RT used for BTC treatment between 2000 and 2011 was conducted by the Japanese Radiation Oncology Study Group. Detailed information was collected for 555 patients from 31 radiation oncology institutions.ResultsThe median age of the patients was 69 years old (range, 33–90) and 81% had a good performance status (0–1). Regarding RT treatment, 78% of the patients were treated with external beam RT (EBRT) alone, 17% received intraluminal brachytherapy, and 5% were treated with intraoperative RT. There was no significant difference in the choice of treatment modality among the BTC subsites. Many patients with EBRT were treated with a total dose of 50 or 50.4 Gy (~40%) and only 13% received a total dose ≥60 Gy, even though most institutions (90%) were using CT-based treatment planning. The treatment field consisted of the primary tumor (bed) only in 75% of the patients. Chemotherapy was used for 260 patients (47%) and was most often administered during RT (64%, 167/260), followed by after RT (63%, 163/260). Gemcitabine was the most frequently used drug for chemotherapy.ConclusionsThis study established the general patterns of RT practice for BTC in Japan. Further surveys and comparisons with results from other countries are needed for development and optimization of RT for patients with BTC in Japan.
Highlights
The patterns of radiotherapy (RT) practice for biliary tract cancer (BTC) in Japan are not clearly established
Regarding the primary site, ~50% of BTC lesions arose in the perihilar regions of the extrahepatic bile duct, with distal regions of the extrahepatic bile duct being the second most common site (26%)
Among all patients, >80% had an Eastern Cooperative Oncology Group performance status of 0–1, ~30% had a drinking or smoking habit, 52% had an unresectable tumor at diagnosis, and 53% had clinical stage T3-4 disease at diagnosis
Summary
The patterns of radiotherapy (RT) practice for biliary tract cancer (BTC) in Japan are not clearly established. In Japan, there were an estimated 20,734 new cases of BTC in 2007, with more than a 3-fold increase over the last three decades [2], while RT has become much more common because new methods and technology for treatment planning are available. For these reasons, optimal management of RT for BTC has become a major concern in Japan. To the best of our knowledge, this is the first report to establish how RT is used nationally to treat BTC in Japan
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