Abstract
Gall bladder cancer (GBC) represents the most common biliary tract malignancy, it however it is a rare malignancy overall. Historical work has established complete resection as standard of care. Despite R0 resection the local recurrence (LR) rates remain high. High LR rates prompted interest in study of role of adjuvant therapy in form of radiotherapy and/ or chemotherapy after resection. We attempt to review the role of adjuvant radiotherapy in GBC and also to discuss prognostic factors and key problems in management of gall bladder cancers.
Keyword: Gall Bladder Cancer, Adjuvant Radiotherapy.
References
- National Cancer Registry Programme, Indian Council of Medical Research: Three Year Report of Population Based Cancer Registries; 2009-2011. ICMR, Three Year Report of the PBCRs: 2006-2008; 2008. Available from: http://www.pbcrindia.org/.
- Nandakumar A, Gupta PC, Gangadharan P, Visweswara RN, Parkin DM. Geographic pathology revisited: Development of an atlas of cancer in India. Int J Cancer 2005;116:740-54.
- Piehler JM, Crichlow RW. Primary carcinoma of the gallbladder. Surg Gynecol Obstet 1978;147:929-42. [PUBMED]
- Misra S, Chaturevedi A, Misra NC, Sharma ID. Carcinoma of the gall bladder. Lancet Oncol 2003;4:167-76.
- Morrow CE, Sutherland DE, Florack G, Eisenberg MM, Grage TB. Primary gallbladder carcinoma: Significance of subserosal lesions and results of aggressive surgical treatment and adjuvant chemotherapy. Surgery 1983;94:709-14. [PUBMED]
- Shirai Y, Yoshida K, Tsukada K, Muto T. Inapparent carcinoma of the gallbladder. An appraisal of a radical second operation after simple cholecystectomy. Ann Surg 1992;215:326-31.
- Muratore A, Polastri R, Bouzari H, Vergara V, Capussotti L. Radical surgery for gallbladder cancer: A worthwhile operation? Eur J SurgOncol 2000;26:160-3.
- Kresl JJ, Schild SE, Henning GT, Gunderson LL, Donohue J, Pitot H, et al. Adjuvant external beam radiation therapy with concurrent chemotherapy in the management of gallbladder carcinoma. Int J Radiat Oncol Biol Phys 2002;52:167-75.
- Vaittinen E. Carcinoma of the gall-bladder. A study of 390 cases diagnosed in Finland 1953-1967. Ann ChirGynaecol Fenn Suppl 1970;168:1-81.
- Brian G. CzitoM.D., Herbert I.Hurwitz M.D., et al. Adjuvant external-beam radiotherapy with concurrent chemotherapy after resection of primary gallbladder carcinoma: A 23-year experience international journal of radiation oncology*biology*physics 2005:1030-34.
- Mahantshetty UM, Palled S R, Engineer R, Homkar G, Shrivastava S K, Shukla P J. Adjuvant radiation therapy in gall bladder cancers: 10 years experience at Tata Memorial Hospital. J Can Res Ther 2006;2:52-6
- Mojica P, Smith D, Ellenhorn J. Adjuvant radiation therapy is associated with improved survival for gallbladder carcinoma with regional metastatic disease.J SurgOncol 2007;96:8-13. 10.1002/jso.20831 [PubMed] [CrossRef] [Google Scholar]
- Wang SJ, Fuller CD, Kim JS, et al. Prediction model for estimating the survival benefit of adjuvant radiotherapy for gallbladder cancer.J ClinOncol 2008;26:2112-7. 10.1200/JCO.2007.14.7934 [PubMed] [CrossRef] [Google Scholar]
- Wang SJ, Lemieux A, Kalpathy-Cramer J, et al. Nomogram for predicting the benefit of adjuvant chemoradiotherapy for resected gallbladder cancer.J ClinOncol 2011;29:4627-32. 10.1200/JCO.2010.33.8020 [PMC free article] [PubMed] [CrossRef] [Google Scholar]
- Horgan AM, Amir E, Walter T, et al. Adjuvant therapy in the treatment of biliary tract cancer: a systematic review and meta-analysis.J ClinOncol 2012;30:1934-40. 10.1200/JCO.2011.40.5381 [PubMed] [CrossRef] [Google Scholar]
- Ben-Josef E, Guthrie KA, El-Khoueiry AB, et al. SWOG S0809: A Phase II Intergroup Trial of Adjuvant Capecitabine and Gemcitabine Followed by Radiotherapy and Concurrent Capecitabine in ExtrahepaticCholangiocarcinoma and Gallbladder Carcinoma.J Clin Oncol 2015; 33:2617-22. 10.1200/JCO.2014.60.2219 [PMC free article] [PubMed] [CrossRef] [Google Scholar]
- Hassan, m. (2019).Role of adjuvant therapy in resected gallbladder cancer. | Journal of Clinical Oncology. [online] Ascopubs.org. Available at: https://ascopubs.org/doi/abs/10.1200/JCO.2018.36.4_suppl.452
- Vaittinen E. Carcinoma of the gall-bladder. A study of 390 cases diagnosed in Finland 1953-1967. Ann ChirGynaecol 1970;168:1-81.
- Todoroki T, Gunderson LL, Nagorney D, et al . Biliary tract IORT: Bile duct and gall bladder. Intraoperative irradiation techniques and results. Humana Press: Totowa, NJ; 1999. p. 223-49.
- Eisbruch A, Dawson LA, Kim HM, Bradford CR, Terrell JE, Chepeha DB, et al. Conformal and intensity modulated irradiation of head and neck cancer: The potential for improved target irradiation, salivary gland function, and quality of life. ActaOtorhinolaryngolBelg 1999;53:271-5.
- Wu Q, Manning M, Schmidt-Ullrich R, Mohan R. The potential for sparing of parotids and escalation of biologically effective dose with intensity-modulated radiation treatments of head and neck cancers: A treatment design study. Int J RadiatOncolBiolPhys 2000;46:195-205.
Corresponding Author
Dr Kushboo Jain
3rd year Resident, MD Radiation Oncology, Department of Radiotherapy, GCRI