Preliminary analyses of efficacy and safety of Cyberknife stereotactic body radiotherapy for 26 patients with recurrent cholangiocellular carcinoma after surgery

Objective: To evaluate the efficacy and safety of stereotactic body radiation therapy (SBRT) using Cyberknife in the treatment of patients with recurrent cholangiocellular carcinoma (RCC) after surgery. Methods: Clinical data of 26 patients with recurrent RCC after surgery undergoing Cyberknife SBRT from 2010 to 2015 were retrospectively analyzed. The median recurrence time was 10 months (range 2.0-63.0 months) and the median tumor diameter was 2.8 cm (range 1.2-4.8 cm). The median prescription dose/fraction was 45 Gy/5f (range 40-50 Gy/3-8 f). The tumor progression was evaluated based on enhanced CT or MRI. Overall survival (OS), progression-free survival (PFS) and local control rate (LC) were analyzed by Kaplan-Meier method. Toxicity was assessed using the common terminology criteria for adverse events version 4.0. Results: For the entire cohort, the median OS and PFS were 13.5 months and 6.5 months at a median follow-up of 29.3 months (range 2.1-62.0 months). The 1- and 2- year OS and PFS rates were 52% and 21% as well as 28% and 15%, respectively. Among them, 4 patients (4/26, 15%) were recurrent in situ after SBRT. Three patients experienced grade III adverse reactions including 1 case of gastrointestinal reaction, 1 case of liver dysfunction and 1 case of biliary tract infection. Only 1 patient suffered from ≥ grade IV gastrointestinal bleeding during the advanced stage. Conclusions: SBRT using Cyberknife is a safe and effective treatment for patients with recurrent RCC after surgery. The adverse reactions can be tolerated by patients. (authors)