Thermo-chemo-radiotherapy for advanced gallbladder carcinoma.
OBJECTIVE
Many gallbladder carcinomas are detected at an advanced stage, and the outcome of the patients with these tumors is dismal despite aggressive tumor removal. We have treated advanced gallbladder carcinoma with chemoradiotherapy combined with hyperthermia. In this study, clinical effectiveness of thermo-chemo-radiotherapy (TCRT) for advanced gallbladder carcinoma was evaluated in comparison with other treatment modalities.


METHODS
Two hundred and seventy patients with advanced gallbladder carcinoma (Stage VI) were treated. According to treatments received, they were divided into five groups as follows: group 1; 30 patients treated with TCRT, group 2; 19 patients underwent R0-resection, group 3; 39 patients underwent R1,2-resection, group 4; 57 patients treated with chemo- and/or radiotherapy, group 5; 125 patients with only supportive therapy.


RESULTS
In group 1, there were 19 objective responses (5 complete response and 14 partial response) in respect to tumor regression, and 15 (6 complete response and 9 partial response) of 20 patients with obstructed bile duct showed resolution of the bile duct. The survival rate was best in group 2. A significant improvement of long-term survival was exhibited in group 1 and 3 compared to group 4 and 5, and there was no significant difference between group 1 and 3 (p<0.01).


CONCLUSIONS
TCRT can produce significant response and improvement of survival time in patients with advanced gallbladder carcinoma, and may be a favorable alternative to aggressive surgical approaches.
Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan. kamisawa@cick.jp
Terumi
T
Kamisawa
Yuyang
Y
Tu
Jun-ichi
J
Ishiwata
Katsuyuki
K
Karasawa
Tadayoshi
T
Matsuda
Tsuneo
T
Sasaki
Nobuaki
N
Funata
Kouji
K
Tsuruta
Atsutake
A
Okamoto
Toshio
T
Takahashi
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents; D002277:Carcinoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D002763:Cholecystectomy; D003131:Combined Modality Therapy; D005260:Female; D005706:Gallbladder Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006801:Humans; D006979:Hyperthermia, Induced; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D015996:Survival Rate
D000970:Antineoplastic Agents