Treatment outcomes for unresectable intrahepatic cholangiocarcinoma: Nationwide, population-based, cohort study based on propensity score matching with the Mahalanobis metric

Wei Wen Chang, Ping Kun Hsiao, Lei Qin, Chia Lun Chang, Jyh Ming Chow, Szu Yuan Wu

研究成果: 雜誌貢獻文章

4 引文 (Scopus)

摘要

Purpose: No prospective randomized trials have been conducted to date to evaluate the efficacy of palliation of pain or jaundice without treatment, definitive concurrent chemoradiotherapy (CCRT), sequential chemotherapy and radiotherapy (CTRT), or chemotherapy (CT) alone for treating unresectable intrahepatic cholangiocarcinoma (ICC). We designed a nationwide, population-based, cohort study to determine the effects of different treatments on patients with unresectable ICC using propensity score matching (PSM) with the Mahalanobis metric. Patients and methods: We classified patients with unresectable ICC from the Taiwan Cancer Registry database into the following 4 treatment groups: group 1, definitive CCRT; group 2, sequential CTRT; group 3, no treatment (palliative therapy for relief of pain, pruritus, or jaundice); and group 4, CT alone. Confounding factors among the 4 treatment groups were minimized through propensity score matching (PSM). Results: After PSM, the final cohort consisted of 844 patients (211 patients in each of the 4 groups). In both univariable and multivariable Cox regression analyses, adjusted hazard ratios (aHRs; 95% confidence interval [CI]) derived for groups 1 and 2 compared with group 4 were 0.65 (0.59–0.71) and 0.95 (0.83–1.48), respectively. Furthermore, an aHR (95% CI) of 2.25 (1.89–2.67) was derived for significant independent prognostic risk factors for poor overall survival for group 3 compared with group 4. Conclusions: Definitive CCRT is the optimal therapy for patients with unresectable ICC without distant metastasis.
原文英語
頁(從 - 到)1-9
期刊Radiotherapy and Oncology
DOIs
出版狀態接受/付印 - 一月 1 2018

指紋

Propensity Score
Cholangiocarcinoma
Cohort Studies
Chemoradiotherapy
Population
Drug Therapy
Jaundice
Radiotherapy
Therapeutics
Confidence Intervals
Pain
Pruritus
Taiwan
Palliative Care
Registries
Regression Analysis
Databases
Neoplasm Metastasis
Survival
Neoplasms

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Radiology Nuclear Medicine and imaging

引用此文

@article{33a9ff7faa624ef08de6f78acd2b5190,
title = "Treatment outcomes for unresectable intrahepatic cholangiocarcinoma: Nationwide, population-based, cohort study based on propensity score matching with the Mahalanobis metric",
abstract = "Purpose: No prospective randomized trials have been conducted to date to evaluate the efficacy of palliation of pain or jaundice without treatment, definitive concurrent chemoradiotherapy (CCRT), sequential chemotherapy and radiotherapy (CTRT), or chemotherapy (CT) alone for treating unresectable intrahepatic cholangiocarcinoma (ICC). We designed a nationwide, population-based, cohort study to determine the effects of different treatments on patients with unresectable ICC using propensity score matching (PSM) with the Mahalanobis metric. Patients and methods: We classified patients with unresectable ICC from the Taiwan Cancer Registry database into the following 4 treatment groups: group 1, definitive CCRT; group 2, sequential CTRT; group 3, no treatment (palliative therapy for relief of pain, pruritus, or jaundice); and group 4, CT alone. Confounding factors among the 4 treatment groups were minimized through propensity score matching (PSM). Results: After PSM, the final cohort consisted of 844 patients (211 patients in each of the 4 groups). In both univariable and multivariable Cox regression analyses, adjusted hazard ratios (aHRs; 95{\%} confidence interval [CI]) derived for groups 1 and 2 compared with group 4 were 0.65 (0.59–0.71) and 0.95 (0.83–1.48), respectively. Furthermore, an aHR (95{\%} CI) of 2.25 (1.89–2.67) was derived for significant independent prognostic risk factors for poor overall survival for group 3 compared with group 4. Conclusions: Definitive CCRT is the optimal therapy for patients with unresectable ICC without distant metastasis.",
keywords = "Chemotherapy alone, Concurrent chemoradiotherapy, Intrahepatic cholangiocarcinoma, Sequential chemoradiotherapy, Survival",
author = "Chang, {Wei Wen} and Hsiao, {Ping Kun} and Lei Qin and Chang, {Chia Lun} and Chow, {Jyh Ming} and Wu, {Szu Yuan}",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.radonc.2018.09.010",
language = "English",
pages = "1--9",
journal = "Radiotherapy and Oncology",
issn = "0167-8140",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Treatment outcomes for unresectable intrahepatic cholangiocarcinoma

T2 - Nationwide, population-based, cohort study based on propensity score matching with the Mahalanobis metric

AU - Chang, Wei Wen

AU - Hsiao, Ping Kun

AU - Qin, Lei

AU - Chang, Chia Lun

AU - Chow, Jyh Ming

AU - Wu, Szu Yuan

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Purpose: No prospective randomized trials have been conducted to date to evaluate the efficacy of palliation of pain or jaundice without treatment, definitive concurrent chemoradiotherapy (CCRT), sequential chemotherapy and radiotherapy (CTRT), or chemotherapy (CT) alone for treating unresectable intrahepatic cholangiocarcinoma (ICC). We designed a nationwide, population-based, cohort study to determine the effects of different treatments on patients with unresectable ICC using propensity score matching (PSM) with the Mahalanobis metric. Patients and methods: We classified patients with unresectable ICC from the Taiwan Cancer Registry database into the following 4 treatment groups: group 1, definitive CCRT; group 2, sequential CTRT; group 3, no treatment (palliative therapy for relief of pain, pruritus, or jaundice); and group 4, CT alone. Confounding factors among the 4 treatment groups were minimized through propensity score matching (PSM). Results: After PSM, the final cohort consisted of 844 patients (211 patients in each of the 4 groups). In both univariable and multivariable Cox regression analyses, adjusted hazard ratios (aHRs; 95% confidence interval [CI]) derived for groups 1 and 2 compared with group 4 were 0.65 (0.59–0.71) and 0.95 (0.83–1.48), respectively. Furthermore, an aHR (95% CI) of 2.25 (1.89–2.67) was derived for significant independent prognostic risk factors for poor overall survival for group 3 compared with group 4. Conclusions: Definitive CCRT is the optimal therapy for patients with unresectable ICC without distant metastasis.

AB - Purpose: No prospective randomized trials have been conducted to date to evaluate the efficacy of palliation of pain or jaundice without treatment, definitive concurrent chemoradiotherapy (CCRT), sequential chemotherapy and radiotherapy (CTRT), or chemotherapy (CT) alone for treating unresectable intrahepatic cholangiocarcinoma (ICC). We designed a nationwide, population-based, cohort study to determine the effects of different treatments on patients with unresectable ICC using propensity score matching (PSM) with the Mahalanobis metric. Patients and methods: We classified patients with unresectable ICC from the Taiwan Cancer Registry database into the following 4 treatment groups: group 1, definitive CCRT; group 2, sequential CTRT; group 3, no treatment (palliative therapy for relief of pain, pruritus, or jaundice); and group 4, CT alone. Confounding factors among the 4 treatment groups were minimized through propensity score matching (PSM). Results: After PSM, the final cohort consisted of 844 patients (211 patients in each of the 4 groups). In both univariable and multivariable Cox regression analyses, adjusted hazard ratios (aHRs; 95% confidence interval [CI]) derived for groups 1 and 2 compared with group 4 were 0.65 (0.59–0.71) and 0.95 (0.83–1.48), respectively. Furthermore, an aHR (95% CI) of 2.25 (1.89–2.67) was derived for significant independent prognostic risk factors for poor overall survival for group 3 compared with group 4. Conclusions: Definitive CCRT is the optimal therapy for patients with unresectable ICC without distant metastasis.

KW - Chemotherapy alone

KW - Concurrent chemoradiotherapy

KW - Intrahepatic cholangiocarcinoma

KW - Sequential chemoradiotherapy

KW - Survival

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U2 - 10.1016/j.radonc.2018.09.010

DO - 10.1016/j.radonc.2018.09.010

M3 - Article

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SP - 1

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JO - Radiotherapy and Oncology

JF - Radiotherapy and Oncology

SN - 0167-8140

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