{"doi":"10.1159/000530134","title":"Definitive Liver Radiotherapy for Intrahepatic Cholangiocarcinoma with Extrahepatic Metastases","abstract":"Introduction: Tumor-related liver failure (TRLF) is the most common cause of death in patients with intrahepatic cholangiocarcinoma (ICC). Though we previously showed that liver radiotherapy (L-RT) for locally advanced ICC is associated with less frequent TRLF and longer overall survival (OS), the role of L-RT for patients with extrahepatic metastatic disease (M1) remains undefined. We sought to compare outcomes for M1 ICC patients treated with and without L-RT. Methods: We reviewed ICC patients that found to have M1 disease at initial diagnosis at a single institution between 2010 and 2021 who received L-RT, matching them with an institutional cohort by propensity score and a National Cancer Database (NCDB) cohort by frequency technique. The median biologically effective dose was 97.5 Gy (interquartile range 80.5–97.9 Gy) for L-RT. Patients treated with other local therapies or supportive care alone were excluded. We analyzed survival with Cox proportional hazard modeling. Results: We identified 61 patients who received L-RT and 220 who received chemotherapy alone. At median follow-up of 11 months after diagnosis, median OS was 9 months (95% confidence interval [CI] 8–11) and 21 months (CI: 17–26) for patients receiving chemotherapy alone and L-RT, respectively. TRLF was the cause of death more often in the patients who received chemotherapy alone compared to those who received L-RT (82% vs. 47%; p = 0.001). On multivariable propensity score-matched analysis, associations with lower risk of death included duration of upfront chemotherapy (hazard ratio [HR] 0.82; p = 0.005) and receipt of L-RT (HR: 0.40; p = 0.002). The median OS from diagnosis for NCDB chemotherapy alone cohort was shorter than that of the institutional L-RT cohort (9 vs. 22 months; p < 0.001). Conclusion: For M1 ICC, L-RT associated with a lower rate of death due to TRLF and longer OS versus those treated with chemotherapy alone. Prospective studies of L-RT in this setting are warranted.","journal":"Liver Cancer","year":2023,"id":344086,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":13,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9614,"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":975766,"name":"Rituraj Upadhyay","orcid":"0000-0003-4079-1268","position":1,"is_corresponding":false},{"id":423549,"name":"Kaiping Liao","orcid":"0009-0007-5908-1668","position":2,"is_corresponding":false},{"id":1083016,"name":"Tiffany Kumala","orcid":null,"position":3,"is_corresponding":false},{"id":893059,"name":"Christopher Shi","orcid":"0000-0002-9222-8365","position":4,"is_corresponding":false},{"id":1083017,"name":"Grace Dodoo","orcid":null,"position":5,"is_corresponding":false},{"id":405444,"name":"Joseph Abi Jaoude","orcid":"0000-0002-2283-4765","position":6,"is_corresponding":false},{"id":449670,"name":"Kelsey L. 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Tran Cao","orcid":"0000-0001-8612-8272","position":15,"is_corresponding":false},{"id":297692,"name":"Grace Lee","orcid":"0000-0001-7892-2871","position":16,"is_corresponding":false},{"id":43396,"name":"Jennifer Y. Wo","orcid":"0000-0001-9872-5912","position":17,"is_corresponding":false},{"id":43397,"name":"Theodore S. Hong","orcid":"0000-0001-8481-6581","position":18,"is_corresponding":false},{"id":305046,"name":"Christopher H. Crane","orcid":"0000-0001-5143-2784","position":19,"is_corresponding":false},{"id":72433,"name":"Bruce D. Minsky","orcid":"0000-0001-8434-7930","position":20,"is_corresponding":false},{"id":380273,"name":"Grace L. Smith","orcid":"0000-0002-3171-2911","position":21,"is_corresponding":false},{"id":428202,"name":"Emma B. Holliday","orcid":"0000-0002-4362-461X","position":22,"is_corresponding":false},{"id":60605,"name":"Cullen M. Taniguchi","orcid":"0000-0002-8052-3316","position":23,"is_corresponding":false},{"id":254922,"name":"Albert C. Koong","orcid":"0000-0001-9824-1643","position":24,"is_corresponding":false},{"id":341838,"name":"Prajnan Das","orcid":"0000-0002-3845-0707","position":25,"is_corresponding":false},{"id":226645,"name":"Milind Javle","orcid":"0000-0001-9158-0941","position":26,"is_corresponding":false},{"id":355311,"name":"Ethan B. Ludmir","orcid":"0000-0002-5472-5344","position":27,"is_corresponding":false},{"id":227744,"name":"Eugene J. 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