Prospective Evaluation Fiducial Migration after Placement for Liver SBRT and Influence on Treatment Delivery

Abstract

The role of adjuvant treatment for patients with resected perihilar cholangiocarcinoma (PC) remains controversial, and there is no consensus regarding patient selection for adjuvant radiotherapy and chemotherapy. The objective of this study was to investigate the benefits of adjuvant treatment for patients with resected PC. Materials/Methods: Between 2001 and 2017, 205 patients with PC underwent curative resection. The patients were divided into four groups according to adjuvant treatment types: surgery alone (n Z 96), surgery with chemotherapy (CTx, n Z 66), surgery with radiotherapy (RTx, n Z 18), and surgery with chemoradiotherapy (CRT, n Z 25). Results: The median follow-up of surviving patients was 46 months (range, 9e188 months). The 5-year rates of disease free survival (DFS), overall survival (OS) for all patients were 27.2%, and 34.4%, respectively. Multivariate analysis showed that surgery with CRT was a significant prognostic factor for DFS and OS. In the subgroup analyses of the R1 resection patients, the 5-year OS of surgery with CRT, surgery with RTx, surgery with CTx, and surgery alone was 40.4%, 15.2%, 9.1%, and 7.7%, respectively. In the subgroup analyses of the positive lymph nodes and R0 resection patients, the 5-year OS of surgery with CRT, surgery with RTx, surgery with CTx, and surgery alone was 66.7%, 42.1%, 0%, and 0%, respectively. Conclusion: Adjuvant CRT is associated with improved survival in PC patients with R1 resection, or positive lymph nodes and R0 resection. Our data suggest that adjuvant RTx and CTx should be considered in high-risk resected PC patients.