{"doi":"10.1016/j.adro.2023.101412","title":"Survival and Toxicity in Patients With Unresectable or Inoperable Biliary Tract Cancers With Ablative Radiation Therapy Versus Nonablative Chemoradiation","abstract":"Purpose Conventional chemoradiation (CCRT) is inadequately effective for the treatment of unresectable or inoperable biliary tract cancers (UIBC). Ablative radiotherapy (AR), typically defined as a biologically effective dose (BED) ≥ 80.5 Gy, has shown some promise in terms of local control and survival in these patients. We compare the efficacy and toxicity of AR to non-AR in UIBC patients. Methods Patients with UIBC treated with stereotactic body radiotherapy (SBRT) (n = 18) or CCRT (n = 28) between 2006 and 2021 were retrospectively analyzed. The associations of treatment, BED groups, and selected characteristics with overall survival (OS), progression-free survival (PFS), and local control (LC) were estimated separately using Cox proportional hazards regression. Toxicity was scored using CTCAE v5.0. Results Median dose fractionation was 60 Gy in 5 fx (median BED 127 Gy) for SBRT and 50 Gy in 25 fx (median BED 64 Gy) for CCRT. The median follow-up of the entire cohort was 11.5 months. The 1-year OS rate was 62% for BED < 80.5 versus 66% for BED ≥ 80.5 (p = 0.069). The 1-year PFS rate was 24% for BED < 80.5 and 29% for BED ≥ 80.5 (p = 0.050). The 1-year LC rate was 20% for BED < 80.5 and 41% for BED ≥ 80.5 (p = 0.097). BED as a continuous variable (p= 0.013), BED ≥ 100 Gy (p = 0.044), and race [white vs. nonwhite] (p= 0.037) were associated with improved overall mortality. BED ≥ 80.5 Gy (p = 0.046), smaller tumor size [<5 cm] (p = 0.038) and N0 disease (p < 0.0001) were associated with improved disease progression rates. Local control was improved in patients with N0 disease compared to N1 disease (p < 0.0001). Both treatments were well tolerated; there was no difference in acute and late toxicity between AR and non-AR. Conclusions In this review, there was improved PFS with BED ≥ 80.5 Gy with a trend towards OS benefit. BED ≥ 80.5 Gy was achieved mostly through SBRT and was well tolerated. AR could be considered a more effective treatment modality than CCRT in patients with UIBC.","journal":"Advances in Radiation Oncology","year":2023,"id":378113,"datarank":0.24141568686511508,"base_score":1.6094379124341003,"endowment":1.6094379124341003,"self_citation_contribution":0.24141568686511508,"citation_network_contribution":0.0,"self_endowment_contribution":0.24141568686511508,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9544,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":517115,"name":"Karen Ruth","orcid":null,"position":1,"is_corresponding":false},{"id":516496,"name":"Efrat Dotan","orcid":"0000-0002-5762-512X","position":2,"is_corresponding":false},{"id":339898,"name":"Sanjay S. Reddy","orcid":"0000-0001-9306-2574","position":3,"is_corresponding":false},{"id":385806,"name":"Joshua E. Meyer","orcid":"0000-0002-7585-5738","position":4,"is_corresponding":false},{"id":1142075,"name":"H.N. Yankey","orcid":"0009-0009-1371-5359","position":0,"is_corresponding":true}],"reference_count":22,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T01:16:44.708019Z","pmid":"38778829","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}