| Zhao Qianqian,Zhou Jian,Fan Jia,Shi Guoming,Du Shisuo,Chen Yixing,Yang Ping,Zeng Zhaochong.Efficacy and safety of radiotherapy combined with targeted therapy, immunotherapy and chemotherapy for unresectable intrahepatic cholangiocarcinoma[J].Chinese Journal of Radiological Medicine and Protection,2023,43(6):425-430 |
| Efficacy and safety of radiotherapy combined with targeted therapy, immunotherapy and chemotherapy for unresectable intrahepatic cholangiocarcinoma |
| Received:April 06, 2023 |
| DOI：10.3760/cma.j.cn112271-20230406-00109 |
| KeyWords:Radiotherapy Lenvatinib Anti-PD-1 antibody Gemcitabine+Oxaliplatin Intrahepatic cholangiocarcinoma |
| FundProject:国家自然科学基金青年基金（82102823）；上海市"科技创新行动计划"扬帆计划（21YF1406900）；中国博士后科学基金面上项目（2021M700832）；北京白求恩公益基金会项目（flzh202122）；国家重点研发计划项目（2022YFC2503704） |
| Author Name | Affiliation | E-mail | | Zhao Qianqian | Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, China | | | Zhou Jian | Department of Liver Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China | | | Fan Jia | Department of Liver Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China | | | Shi Guoming | Department of Liver Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China | | | Du Shisuo | Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, China | | | Chen Yixing | Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, China | | | Yang Ping | Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, China | | | Zeng Zhaochong | Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, China | zeng.zhaochong@zs-hospital.sh.cn |
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| Abstract:: |
| Objective To evaluate the efficacy and safety of quadruple therapy involving radiotherapy (RT), lenvatinib, anti-PD-1 antibody and GEMOX (oxaliplatin and gemcitabine) chemotherapy (quadruple therapy) in treatment cohort of patients with unresectable intrahepatic cholangiocarcinoma (ICC).Methods The patients with recurrent, metastatic, or unresectable ICC underwent quadruple therapy at Zhongshan Hospital, Fudan University between September 2018 and May 2022 were selected. The data about efficacy and safety of quadruple therapy were collected in the hospital electronic medical record system. All patients were followed up regularly to obtain the long-term prognostic data until December 31, 2022. The efficacy, prognosis, and toxicity data were collected and analyzed.Results A total of 41 patients were included in the analysis. After a median follow-up period of 15 months, disease progression was diagnosed in 36 patients (18 patients died), while 3 patients were lost to follow-up. The causes of death included liver failure induced by intrahepatic tumor progression (n=6), distant metastases (lungs or brain, n=6), abdominal lymph node metastases (n=3), cancer cachexia (n=2), and unknown cause (n=1). The median progression-free survival (PFS) was 11 months (95%CI:9.2-12.8), and the median overall survival (OS) was 35 months (95%CI:17.0-52.0). All patients experienced treatment-related adverse events (AEs) during the study treatment period. Of the 41 patients, 13 patients experienced at least once grade 3 or worse treatment-related AE, but all were manageable with symptomatic treatment. No treatment-related deaths were reported during the follow-up period.Conclusions Radiotherapy (RT), lenvatinib, anti-PD-1 antibody and GEMOX in the treatment of unresectable ICC shows significant efficacy and good safety, which is worthy of clinical application. |
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