2012年10月28-31日，第54届美国放射肿瘤学会（ASTRO）年会在美国波士顿举行。来自世界各地的放射肿瘤学领域的医生及相关人士共计11000多人参会。本届年会的主题是“通过创新改善患者治疗（Advancing Patient Care through Innovation）”。金宝搏网站登录技巧 对本届年会进行了专题报道（http://zt.cmt.com.cn/zt/astro2012/index.html），敬请关注！

　　会上，美国学者报告了一项研究：Stereotactic Body Radiation Therapy for Unresectable Intrahepatic and Hilar Cholangiocarcinoma ，其摘要如下：

Purpose/Objective(s)
Surgery offers the only curative treatment for cholangiocarcinoma; however, many patients with intrahepatic and hilar cholangiocarcinoma harbor unresectable disease. The role of conventional radiation therapy and systemic chemotherapy alone, or in combination, for these patients is limited by poor overall outcomes. We investigated the efficacy and toxicity of stereotactic body radiation therapy (SBRT) in these patients.

Materials/Methods
Patients with unresectable, nonmetastatic intrahepatic or hilar cholangiocarcinoma were included in this retrospective study. A multidisciplinary team of Surgeons, and Medical and Radiation oncologists evaluated all patients. Most patients received gemcitabine and cisplatin chemotherapy. Patients received hypofractionated SBRT to their tumor. Three fractions of 8-15 Gy per fraction were delivered in 3 consecutive working days. The doses were determined based on the extent of the tumor and liver tolerance. Patients were followed 1 month after treatment and every 3-4 months thereafter with clinical examination, liver function tests and CT scans.

Results
Twenty patients (11 male and 9 female) with 25 lesions were included in this analysis. Of those patients, 10 received prior systemic therapy and 1 had R2 resection. The mean SBRT dose was 30 Gy in 3 fractions. At a median 26 months follow-up one local failure occurred. Overall response consisted of stable disease (SD) in 13 patients, partial response (PR; any decrease in size) in 5 patients and complete response (CR) in 1 patient. Local control (SD, PR or CR) was achieved in 19 of 20 patients with a 93% local control rate. The median overall survival was 17 months. Nine patients failed within the liver but outside of the treatment area, or systemically. The median progression free survival rate was 13 months and the median liver progression free survival was 16 months. Four patients had grade 3 toxicity consisting of duodenal ulceration in 2 patients, cholangitis in 1 patient and a liver abscess in 1 patient.

Conclusions
The median survival for advanced intrahepatic and hilar cholangiocarcinoma using current therapies is 6-12 months with most patients who develop liver or systemic failure succumbing to their disease. SBRT offers a short, 3-day treatment that does not interfere with systemic therapy. Our results suggest SBRT may be effective and potentially offer local control which in combination with adequate systemic therapy may lead to improved survival.