Efficacy and safety of radiotherapy combined with targeted therapy, immunotherapy and chemotherapy for unresectable intrahepatic cholangiocarcinoma
10.3760/cma.j.cn112271-20230406-00109
- VernacularTitle:放疗联合靶向、免疫治疗和化疗治疗不可手术切除的肝内胆管癌的疗效及安全性研究
- Author:
Qianqian ZHAO
1
;
Jian ZHOU
;
Jia FAN
;
Guoming SHI
;
Shisuo DU
;
Yixing CHEN
;
Ping YANG
;
Zhaochong ZENG
Author Information
1. 复旦大学附属中山医院放疗科，上海 200032
- Keywords:
Radiotherapy;
Lenvatinib;
Anti-PD-1 antibody;
Gemcitabine+ Oxaliplatin;
Intrahepatic cholangiocarcinoma
- From:
Chinese Journal of Radiological Medicine and Protection
2023;43(6):425-430
- CountryChina
- Language:Chinese
-
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.
