J.D. Slater, and G.Y. Yang; Loma Linda University Medical Center, Loma. Linda, CA. Purpose/Objective(s): To determine the maximum tolerated dose (MTD).
E208
International Journal of Radiation Oncology Biology Physics
Materials/Methods: Institutional Review Board approval was obtained for a study of consecutive patients with unresectable cholangiocarcinoma treated from January 2008 to January 2015. Thirty-six patients were treated in total. Twenty-four received Gemcitabine based chemotherapy sequentially or concurrently. Concurrent Gemcitabine was delivered at 400 mg/m2 weekly for 3 weeks in a 4 week cycle. Systemic Gemcitabine was delivered at 1000 mg/m2 weekly for 3 weeks in a 4 week cycle for 4-6 cycles. Twelve patients received non-gemcitabine based chemotherapy. The most commonly used non-gemcitabine drugs concurrent with radiation were 5FU continuous infusion (225 mg/m2/day) or capecitabine (1700 mg/day) in divided doses during days of radiation. Median dose of radiation was 5040 cGy, range was 4500 cGy to 5400 cGy. Forty-seven percent utilized IMRT vs. 53% 3D. The primary endpoint was one year survival. Results: Patient stages were T1 Z 10%, T2 Z 13%, T3 Z 38%, and T4 Z 39%. Lymph nodal involvement was seen in 42% of patients (N Z 15). Median age was 64 years. Mean follow up was 12.1 months, range was 1 to 21 months. Grade 3+ acute and late GI toxicity was seen in 8% of the patients with no treatment related mortality. One year overall survival was significantly improved in those receiving Gemcitabine and RT 62% vs. non-gemcitabine chemotherapy and RT 23% (P
