title: Outcomes of stereotactic body radiotherapy for unresectable primary or recurrent cholangiocarcinoma.
abstract: OBJECTIVE
  To report the results of stereotactic body radiotherapy (SBRT) for unresectable primary or recurrent cholangiocarcinoma.
  
  
  METHODS
  From January 2005 through August 2013, 58 patients with unresectable primary (n = 28) or recurrent (n = 30) cholangiocarcinoma treated by SBRT were retrospectively analyzed. The median prescribed dose was 45 Gy in 3 fractions (range, 15 to 60 Gy in 1-5 fractions). Patients were treated by SBRT only (n = 53) or EBRT + SBRT boost (n = 5). The median tumor volume was 40 mL (range, 5 to 1,287 mL).
  
  
  RESULTS
  The median follow-up duration was 10 months (range, 1 to 97 months). The 1-year, 2-year overall survival rates, and median survival were 45%, 20%, and 10 months, respectively. The median survival for primary group and recurrent group were 5 and 13 months, respectively. Local control rate at 1-year and 2-year were 85% and 72%, respectively. Disease progression-free survival rates at 1-year and 2-year were 26% and 23%, respectively. In univariate analysis, ECOG performance score (0-1 vs. 2-3), treatment volume (<50 vs. ≥50 mL), and pre-SBRT CEA level (<5 vs. ≥5 ng/mL) were significant in overall survival rate. In multivariate analysis, ECOG score (p = 0.037) and tumor volume (p = 0.030) were statistically significant. In the recurrent tumor group, patients with >12 months interval from surgery to recurrence showed statistically significant higher overall survival rate than those with ≤12 months (p = 0.026). Six patients (10%) experienced ≥grade 3 complications.
  
  
  CONCLUSIONS
  SBRT can be considered as an effective local modality for unresectable primary or recurrent cholangiocarcinoma.
authors.affiliation: Department of Radiation Oncology, Korea Institute of Radiological & Medical Sciences, Seoul, Korea.
authors.forename: Da Hoon
authors.initials: DH
authors.lastname: Jung
authors.affiliation: Department of Radiation Oncology, Korea Institute of Radiological & Medical Sciences, Seoul, Korea.
authors.forename: Mi-Sook
authors.initials: MS
authors.lastname: Kim
authors.affiliation: Department of Radiation Oncology, Korea Institute of Radiological & Medical Sciences, Seoul, Korea.
authors.forename: Chul Koo
authors.initials: CK
authors.lastname: Cho
authors.affiliation: Department of Radiation Oncology, Korea Institute of Radiological & Medical Sciences, Seoul, Korea.
authors.forename: Hyung Jun
authors.initials: HJ
authors.lastname: Yoo
authors.affiliation: Department of Radiation Oncology, Korea Institute of Radiological & Medical Sciences, Seoul, Korea.
authors.forename: Won Il
authors.initials: WI
authors.lastname: Jang
authors.affiliation: Department of Radiation Oncology, Korea Institute of Radiological & Medical Sciences, Seoul, Korea.
authors.forename: Young Seok
authors.initials: YS
authors.lastname: Seo
authors.affiliation: Department of Radiation Oncology, Korea Institute of Radiological & Medical Sciences, Seoul, Korea.
authors.forename: Eun Kyung
authors.initials: EK
authors.lastname: Paik
authors.affiliation: Department of Radiation Oncology, Korea Institute of Radiological & Medical Sciences, Seoul, Korea.
authors.forename: Kum Bae
authors.initials: KB
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Korea Institute of Radiological & Medical Sciences, Seoul, Korea.
authors.forename: Chul Ju
authors.initials: CJ
authors.lastname: Han
authors.affiliation: Department of Surgical Oncology, Korea Institute of Radiological & Medical Sciences, Seoul, Korea.
authors.forename: Sang Bum
authors.initials: SB
authors.lastname: Kim
keywords: Cholangiocarcinoma; Radiosurgery