Chemoradiation of locally advanced biliary cancer - A PRISMA-compliant systematic review

Sep 21, 2026

Biliary tract cancers are rare and aggressive; standard care for locally advanced or unresectable disease relies mainly on chemotherapy, with a median overall survival around 12 months. International guidance still considers concurrent chemoradiation as an alternative. This PRISMA-compliant systematic review evaluates modern concurrent CRT evidence for primary or recurrent unresectable BTC, identifying 17 studies and summarizing pooled survival and toxicity outcomes.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages16

Reading Time40 min

AccessFree to download

Abstract

Introduction

Materials and Methods

Results

Conclusion

Keywords

1 | Introduction

DOI: 10. 1002/cam4 .70196 REVIEW Chemoradiation of locally advanced biliary cancer: A PRISMA-compliant systematic review Silvia Bisello1 | Claudio Malizia2 | Filippo Mammini3 | Erika Galietta3 | Federica Medici3 | Gian Carlo Mattiucci4,5 | Francesco Cellini5,6 | Andrea Palloni7 | Luca Tagliaferri8 | Gabriella Macchia9 | Francesco Deodato8 | Savino Cilla10 | Giovanni Brandi7 | Alessandra Arcelli3,11 | Alessio G. Morganti3,11 1Radiation Oncology, AOU delle Marche, Ancona, Italy 2Nuclear Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy 3Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-Bologna University, Bologna, Italy 4UOC Radioterapia Oncologica, Mater Olbia Hospital, Olbia, Italy 5Dipartimento Universitario Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Università Cattolica del Sacro Cuore, Rome, Italy 6Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy 7Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy 8Dipartimento di Diagnostica per Immagini, U.O.C. Radioterapia Oncologica, Radioterapia Oncologica Ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy 9Radiation Oncology Unit, Gemelli Molise Hospital-Università Cattolica del Sacro Cuore, Campobasso, Italy 10Medical Physics Unit, Gemelli Molise Hospital, Campobasso, Italy 11Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy Correspondence Erika Galietta, Radiation Oncology, DIMEC, Alma Mater StudiorumBologna University; Via Albertoni 15, Bologna 40138, Italy. Email: [erika.galietta2@unibo.it](erika.galietta2@unibo.it) Abstract Introduction: Biliary tract cancers (BTC) are rare and aggressive neoplasms. The current management of locally advanced or unresectable BTC is primarily based on chemotherapy (CHT) alone, linked to a median overall survival (OS) of approximately 12 months. However, international guidelines still consider concurrent chemoradiation (CRT) as an alternative treatment option. This study aims to review the current evidence on “modern” CRT for primary or recurrent unresectable BTC. Materials and Methods: A comprehensive search was conducted on PubMed, Scopus, and Cochrane Library to identify relevant papers. Prospective or retrospective trials reporting outcomes after concurrent CRT of unresectable nonmetastatic, primary, or recurrent BTC were included. Only English-written papers published between January 2010 and June 2022 were considered. Results: Seventeen papers, comprising a total of 1961 patients, were included in the analysis. Among them, 11 papers focused solely on patients with primary This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2024 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd. Cancer Medicine. 2024;13:e70196 . [https://doi.org/10.1002/cam4.70196](https://doi.org/10.1002/cam4.70196) [wileyonlinelibrary.com/journal/cam4](wileyonlinelibrary.com/journal/cam4) 1 of 16 unresectable BTC, while two papers included patients with isolated local recurrences and four papers encompassed both settings. In terms of tumor location, 12 papers included patients with intrahepatic, extrahepatic, and hilar BTC, as well as gallbladder cancer. The median CRT dose delivered was 50.4 Gy (range: 45.0– 72.6 Gy) using conventional fractionation. Concurrent CHT primarily consisted of 5-Fluorouracil or Gemcitabine. The pooled rates of 1-year progression-free survival (PFS) and OS were 40.9% and 56.2%, respectively. The median 1-and 2-year OS rates were 63.1% and 29.4%, respectively. Grade ≥3 acute gastrointestinal toxicity ranged from 5.6% to 22.2%(median: 10.9%), while grade ≥3 hem

FAQs

What is the primary purpose of this systematic review?

To review the current evidence on modern concurrent chemoradiation for primary or recurrent unresectable biliary tract cancers in a PRISMA-compliant manner.

How were studies selected and what date range was used?

A comprehensive search of PubMed, Scopus, and Cochrane Library identified trials reporting concurrent CRT outcomes for unresectable nonmetastatic, primary, or recurrent BTC, including only English-written papers published from January 2010 to June 2022.

What overall survival and progression-free survival outcomes were reported?

Seventeen studies with 1,961 patients were included. Pooled 1-year progression-free survival and overall survival rates were 40.9% and 56.2%, respectively, with median 1- and 2-year overall survival rates of 63.1% and 29.4%.

Sep 21, 2026

Uploaded by Clementine

Chemoradiation of locally advanced biliary cancer - A PRISMA-compliant systematic review_Page 1

Open in WPS to view all 16 pages