Retrospective Cohort Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jun 15, 2019; 11(6): 489-498
Published online Jun 15, 2019. doi: 10.4251/wjgo.v11.i6.489
Clinical efficacy of gemcitabine and cisplatin-based transcatheter arterial chemoembolization combined with radiotherapy in hilar cholangiocarcinoma
Wen-Heng Zheng, Tao Yu, Ya-Hong Luo, Ying Wang, Ye-Fu Liu, Xiang-Dong Hua, Jie Lin, Zuo-Hong Ma, Fu-Lu Ai, Tian-Lu Wang
Wen-Heng Zheng, Tao Yu, Ya-Hong Luo, Ying Wang, Department of Medical Imaging, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang 110042, Liaoning Province, China
Ye-Fu Liu, Xiang-Dong Hua, Zuo-Hong Ma, Department of Hepatobiliary and Pancreatic Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang 110042, Liaoning Province, China
Jie Lin, Fu-Lu Ai, Department of General Surgery (VIP ward), Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang 110042, Liaoning Province, China
Tian-Lu Wang, Department of Radiotherapy, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang 110042, Liaoning Province, China
Author contributions: Zheng WH was responsible for study design, data collection and analysis, and manuscript writing and proofreading; Yu T was responsible for study design and manuscript writing and proofreading; Luo YH and Wang Y performing the research and data analysis; Liu YF, Hua XD, and Lin J performed data collection and proofreading; Ma ZH, Ai FL, and Wang TL performed data analysis.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board of the Liaoning Cancer Hospital.
Informed consent statement: Informed consent was waived by the Institutional Review Board of the Liaoning Cancer Hospital because this study is a retrospective study.
Conflict-of-interest statement: None of the authors has any conflict of interest.
STROBE statement: The STROBE of checklist items has been included in the manuscript.
Data sharing statement: No additional data are available.
Open-Access: This is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Tao Yu, MD, PhD, Chief Doctor, Department of Medical Imaging, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, No. 44, Xiaoheyan Road, Dadong District, Shenyang 110042, Liaoning Province, China. yutao@cancerhosp-ln-cmu.com
Telephone: +86-18900917557 Fax: +86-24-24315679
Received: March 7, 2019
Peer-review started: March 8, 2019
First decision: May 13, 2019
Revised: May 15, 2019
Accepted: May 28, 2019
Article in press: May 29, 2019
Published online: June 15, 2019
ARTICLE HIGHLIGHTS
Research background

Because of the occultation of hepatic hilar cholangiocarcinoma, most patients have lost the opportunity for surgical radical treatment at the time of diagnosis. Palliative treatment is important for patients with hepatic hilar cholangiocarcinoma.

Research motivation

Simple reduction of jaundice may fail due to tumor progression, and effective and combined palliative treatment may prolong the effective drainage time of the biliary stent or drainage tube, thereby prolonging patient survival. However, relevant research is rare at present.

Research objectives

This study mainly investigated the effects of transcatheter arterial chemoembolization (TACE) combined with radiotherapy on the survival of patients with hilar cholangiocarcinoma after biliary stent or drainage tube implantation, and analyzed the influencing factors.

Research methods

This study used a retrospective cohort analysis to determine the significance of TACE combined with radiotherapy by comparing the differences between the two groups and comparing the different methods of reducing jaundice (stent or drainage tube placement) within the group. Regression analysis of the overall data helps to identify the independent factors influencing survival.

Research results

There was no significant difference in survival between the control group and the combination treatment group, which were treated by stent or tube implantation for the treatment of reducing jaundice, while the survival of patients receiving TACE combined with radiotherapy was significantly longer than that of patients receiving simple reduction of jaundice.

Research conclusions

The results showed that TACE combined with radiotherapy can significantly extend the effective drainage time of stent or tube and prolong the survival of patients. Co-treatment, Bismuth-Corlett type IV, percutaneous biliary drainage, and age were independent predictors of survival.

Research perspectives

Accepting a reasonable and standardized palliative treatment will prolong the survival of patients with unresectable hilar cholangiocarcinoma and improve their living conditions. With the development of immunotherapy and targeted therapy, relevant research may be carried out in the future.