ESTRO meets Asia 2024 - Abstract Book

S280

Interdisciplinary – Upper GI

ESTRO meets Asia 2024

Standard-of-care systemic therapy with or without radiotherapy in patients with unresectable ICC

Qianqian Zhao, Zhaochong Zeng

Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai, China

Purpose/Objective:

The oligometastatic paradigm suggests that some patients with a limited number of metastases might be cured if all lesions are eradicated. We aimed to assess the adding radiotherapy (RT) to standard-of-care systemic therapy on survival, oncological outcomes, and toxicity in patients with unresectable intrahepatic cholangiocarcinoma (ICC).

Material/Methods:

The patients with recurrent, metastatic, or unresectable ICC underwent standard-of-care systemic therapy with or without RT at Zhongshan Hospital, Fudan University between September 2018 and May 2023 were selected. The data about efficacy and safety 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, 2023. The efficacy, prognosis, and toxicity data were collected and analyzed.

Results:

A total of 142 patients were included in the analysis after matching. After a median follow-up period of 18 months, disease progression was diagnosed in 115 patients, while 6 patients were lost to follow-up. The median progression-free survival was 7.2 months (4.5-10.0) for patients in the standard-of-care group versus 12.0 months (95% CI 9.2-13.8) for patients in the RT group (hazard ratio [HR] 0.53, 95% CI 0.35-0.81; p=0.0035). The median overall survival was 12 months (11.1-13.8) for patients in the standard-of-care group versus 19 months (95% CI 15.0-23.8) for patients in the RT group (hazard ratio [HR] 0.53, 95% CI 0.35-0.81; p=0·0035). All patients experienced treatment-related adverse events (AEs) during the study treatment period. The incidences of grade 3 or 4 adverse events were 75.7% and 77.8% in standard-of-care group and RT group, respectively. No treatment-related deaths were reported during the follow-up period.

Conclusion:

Addition of upfront local therapy using RT statistically significantly improved progression-free survival and overall survival for patients with unresectable ICC.

Keywords: unresectable ICC, radiotherapy