scholarly journals Twenty Years of Radiation Therapy of Unresectable Intrahepatic Cholangiocarinoma: Internal or External? A Systematic Review and Meta-Analysis

Liver Cancer ◽  
2021 ◽  
pp. 1-18
Author(s):  
Qian Yu ◽  
Chenyu Liu ◽  
Anjana Pillai ◽  
Osman Ahmed
Keyword(s):  
Systematic Review ◽  
Radiation Therapy ◽  
Survival Time ◽  
Median Survival ◽  
Median Survival Time ◽  
Meta Analysis ◽  
Random Effect Model ◽  
External Beam Radiation ◽  
Complication Rates ◽  
Beam Radiation

<b><i>Purpose:</i></b> Both external beam radiation therapy (EBRT) and selective-internal radiation therapy (SIRT) are implemented to treat unresectable intrahepatic cholangiocarcinoma (iCCA). The present study aimed to evaluate the efficacy of EBRT and SIRT in managing iCCA through a systematic review and meta-analysis. <b><i>Methods:</i></b> PubMed and Cochrane database were queried to search for studies published from January 2000 toJune 2020 without language restrictions. Median survival time, overall survival, and radiological response were extracted. Secondary outcomes such as complication rates, predictors of survival, and downstage to surgery were pooled. Patient-level survival data were obtained to generate Kaplan-Meier survival graph. Pooled outcomes were analyzed with a random-effect model. <b><i>Results:</i></b> Twenty-nine and 20 studies including 732 and 443 patients from the SIRT and EBRT groups were included in the present study. From initial radiation treatment, the median survival time for patients who underwent SIRT and EBRT were 12.0 (95% confidence interval [CI]: 10.8–14.6) and 13.6 (95% CI: 11.1–16.0) months, respectively. As first-line therapy, the median survival time was 36.1 (95% CI: 20.6–39.5) months for SIRT and 11.0 (95% CI: 9.3–13.6) months for EBRT. Both radiation modalities were effective in downstaging initially unresectable iCCA to surgery (SIRT: 30.5%; EBRT: 18.3%). Patients in the SIRT group encountered more post-embolization abdominal pain (6.9 vs. 2.2%), ulcer (1.0 vs. 0.5%), nausea (1.6 vs. 0.7%), anorexia (5.9 vs. 0%), thrombocytopenia (7.3 vs. 6.0%), hyperbilirubinemia (5.2 vs. 2.1%), and hypoalbuminemia (13.2 vs. 3.3%), whereas EBRT was associated with higher rates of anemia (0.6 vs. 7.5%) and neutropenia (6.5 vs. 11.0%). <b><i>Conclusions:</i></b> Both EBRT and SIRT were safe and effective in treating unresectable iCCA. However, available evidence was highly heterogeneous regarding patient population, limiting fair comparison between 2 radiation modalities. Future high-quality comparative studies are warranted.

Resection, biopsy, and survival in malignant glial neoplasms

1993 ◽  
Vol 78 (5) ◽  
pp. 767-775 ◽  
Author(s):  
Bertrand C. Devaux ◽  
Judith R. O'Fallon ◽  
Patrick J. Kelly
Keyword(s):  
Radiation Therapy ◽  
Survival Time ◽  
Median Survival ◽  
Median Survival Time ◽  
Tumor Resection ◽  
External Beam Radiation ◽  
Newly Diagnosed ◽  
Content Type ◽  
Grade Iii ◽  
Fine Print

✓ Between July, 1984, and October, 1988, 263 patients (163 male, 100 female), aged from 4 to 83 years (mean 52 years), with malignant brain gliomas underwent surgical procedures: stereotactic biopsy in 160 and resection in 103 patients. There were 170 grade IV astrocytomas, 17 grade IV mixed oligoastrocytomas, 44 grade III astrocytomas, 22 grade III mixed oligoastrocytomas, and 10 malignant oligodendrogliomas. Overall median survival time was 30.1 weeks for grade IV gliomas, 87.7 weeks for grade III gliomas, and 171.3 weeks for malignant oligodendrogliomas. Multivariate analysis in 218 newly diagnosed cases revealed that the variables most strongly correlated with survival time were: tumor grade, patient age, seizures as a first symptom, a Karnofsky Performance Scale score of less than 70%, tumor resection, and a radiation therapy dose greater than 50 Gy. The proportions of patients receiving tumor resection versus biopsy in each of these prognosis factor groups were similar. Since most of the 22 patients with midline and brain-stem tumors were treated with biopsy alone, these were excluded. Considering 196 newly diagnosed patients with cortical and subcortical tumors, grade IV glioma patients undergoing resection of the contrast-enhancing mass (as evidenced on computerized tomography and magnetic resonance imaging) and postoperative external beam radiation therapy lived longer than those undergoing biopsy only and radiation therapy (median survival time 50.6 weeks and 33.0 weeks, respectively; Smirnov test, p = 0.0380). However, survival in patients with resected grade III gliomas was no better than in those with biopsied grade III lesions (p = 0.746). The authors conclude that, in selected grade IV gliomas, resection of the contrast-enhancing mass followed by radiation therapy is associated with longer survival times than radiation therapy after biopsy alone.

External Beam Radiation Therapy for Resectable Soft Tissue Sarcoma: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 25 (3) ◽  
pp. 754-767 ◽  
Author(s):  
Markus Albertsmeier ◽  
Alexandra Rauch ◽  
Falk Roeder ◽  
Sandro Hasenhütl ◽  
Sebastian Pratschke ◽  
...  
Keyword(s):  
Systematic Review ◽  
Radiation Therapy ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Meta Analysis ◽  
External Beam Radiation Therapy ◽  
External Beam Radiation ◽  
External Beam ◽  
Beam Radiation

Multi-level Model Synthesis of Median Survival Time in Meta-analysis

Epidemiology ◽  
2015 ◽  
Vol 26 (1) ◽  
pp. e2-e3
Author(s):  
Jiajie Zang ◽  
Jinfang Xu ◽  
Chun Xiang ◽  
Jia He ◽  
Shurong Zou
Keyword(s):  
Survival Time ◽  
Median Survival ◽  
Median Survival Time ◽  
Meta Analysis ◽  
Model Synthesis ◽  
Level Model ◽  
Multi Level

scholarly journals Systematic Review of the Relationship between Acute and Late Gastrointestinal Toxicity after Radiotherapy for Prostate Cancer

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Matthew Sean Peach ◽  
Timothy N. Showalter ◽  
Nitin Ohri
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Radiation Therapy ◽  
Late Toxicity ◽  
Gastrointestinal Toxicity ◽  
Acute Injury ◽  
External Beam Radiation ◽  
Beam Radiation ◽  
Gastrointestinal Injury ◽  
Organ Systems

A small but meaningful percentage of men who are treated with external beam radiation therapy for prostate cancer will develop late gastrointestinal toxicity. While numerous strategies to prevent gastrointestinal injury have been studied, clinical trials concentrating on late toxicity have been difficult to carry out. Identification of subjects at high risk for late gastrointestinal injury could allow toxicity prevention trials to be performed using reasonable sample sizes. Acute radiation therapy toxicity has been shown to predict late toxicity in several organ systems. Late toxicities may occur as a consequential effect of acute injury. In this systematic review of published reports, we found that late gastrointestinal toxicity following prostate radiotherapy seems to be statistically and potentially causally related to acute gastrointestinal morbidity as a consequential effect. We submit that acute gastrointestinal toxicity may be used to identify at-risk patients who may benefit from additional attention for medical interventions and close follow-up to prevent late toxicity. Acute gastrointestinal toxicity could also be explored as a surrogate endpoint for late effects in prospective trials.

Radiation therapy in the treatment of canine and feline thymomas: a retrospective study (1985-1999)

2001 ◽  
Vol 37 (5) ◽  
pp. 489-496 ◽  
Author(s):  
AN Smith ◽  
JC Wright ◽  
Brawner WRJr ◽  
SM LaRue ◽  
L Fineman ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Retrospective Study ◽  
Survival Time ◽  
Median Survival ◽  
Stable Disease ◽  
Tumor Size ◽  
Median Survival Time ◽  
Overall Response Rate ◽  
Response Rate ◽  
Clinical Signs

A retrospective study was performed of 17 dogs and seven cats with various stages of thymoma treated with radiation alone or as an adjunctive therapy. Analysis revealed an overall response rate of 75% (15/20 evaluable cases). Partial (i.e., &gt;50% reduction in tumor size) and complete (i.e., no detectable tumor) responses were included. Complete responses were rare (4/20). Three of five animals with stable disease (i.e., &lt;50% change in tumor size) had improvements in clinical signs, despite lack of measurable response. A median survival time of 248 days (range, 93 to 1,657+ days) was achieved in dogs, and a median survival time of 720 days (range, 485 to 1,825+ days) was achieved in cats. Radiation therapy appears to be useful in the management of invasive thymomas in dogs and cats.

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