Multi-modality treatment of primary nonresectable intrahepatic cholangiocarcinoma with 131I anti-cea-A radiation therapy oncology group study

Gary B. Stillwagon, Stanley E. Order, Jerry L. Klein, Peter K. Leichner, Steven A. Leibel, Stanley S. Siegelman, Elliot K Fishman, David S Ettinger, Tom Haulk, Kenneth Kopher, Suzanne M. Brown, Kathy Finney

Research output: Contribution to journalArticle

Abstract

Thirty-seven patients with primary nonresectable intrahepatic cholangiocarcinoma (57% with prior treatment and/or metastasis) were prospectively treated with external radiation, chemotherapy, and 131I labelled anti-CEA. Therapy began in all trials with whole liver irradiation (21.0 Gy, 3.0 Gy/Fx, 4 days/week, 10 MV photons) with alternate treatment day chemotherapy (Adriamycin, 15 mg + 5-FU, 5011 mg). One month after external beam therapy, chemotherapy was given (Adriamycin,15 mg + 5-FU, 500 mg) followed the next day by the first administration of 131I anti-CEA. The treatment schedule used was 20 mCi day 0; 10 mCi day 5 as an outpatient. This schedule was derived from tumor dose estimates which indicated that 20 mCi (8-10 mCi/mg IgG) was sufficient to achieve tumor saturation with a tumor effective half-life of 3 to 5 days, depending upon the species of animal from which the antibody was obtained. The median tumor dose for the 20 mCi + 10 mCi regimen was 6.2 Gy. Antibody therapy was delivered in 2-month cycles using antibody generated in different species of animals; rabbit, pig, monkey, and bovine. Toxicity was limited to hematologic toxicity and was manifested as thrombocytopenia and leukocytopenia (3.2% Grade IV for each according to RTOG toxicity criteria). Tumor remission evaluated by CT scan digitized tumor volume analysis indicated a 26.6% partial response (PR). Tumor remission by physical examination indicated a 333% remission rate (25.9% PR and 7.4% complete remission (CR)). The median survival for patients who responded was 15.2 months. The actuarial median survival for the entire group of patients (metastases and previous treatment) was 6.5 months. The longest partial remission is presently more than 4 years.

Original languageEnglish (US)
Pages (from-to)687-695
Number of pages9
JournalInternational Journal of Radiation Oncology, Biology, Physics
Volume13
Issue number5
DOIs
StatePublished - 1987

Fingerprint

Radiation Oncology
Cholangiocarcinoma
radiation therapy
Radiotherapy
tumors
chemotherapy
antibodies
toxicity
therapy
Neoplasms
metastasis
schedules
Drug Therapy
Fluorouracil
Doxorubicin
Therapeutics
animals
Antibodies
Appointments and Schedules
physical examinations

Keywords

  • Antibodies
  • Biliary tract neoplasms
  • Immunoglobulins
  • Liver neoplasms
  • Neoplasm
  • Radioisotopes

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Multi-modality treatment of primary nonresectable intrahepatic cholangiocarcinoma with 131I anti-cea-A radiation therapy oncology group study. / Stillwagon, Gary B.; Order, Stanley E.; Klein, Jerry L.; Leichner, Peter K.; Leibel, Steven A.; Siegelman, Stanley S.; Fishman, Elliot K; Ettinger, David S; Haulk, Tom; Kopher, Kenneth; Brown, Suzanne M.; Finney, Kathy.

In: International Journal of Radiation Oncology, Biology, Physics, Vol. 13, No. 5, 1987, p. 687-695.

Research output: Contribution to journalArticle

Stillwagon, Gary B. ; Order, Stanley E. ; Klein, Jerry L. ; Leichner, Peter K. ; Leibel, Steven A. ; Siegelman, Stanley S. ; Fishman, Elliot K ; Ettinger, David S ; Haulk, Tom ; Kopher, Kenneth ; Brown, Suzanne M. ; Finney, Kathy. / Multi-modality treatment of primary nonresectable intrahepatic cholangiocarcinoma with 131I anti-cea-A radiation therapy oncology group study. In: International Journal of Radiation Oncology, Biology, Physics. 1987 ; Vol. 13, No. 5. pp. 687-695.
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abstract = "Thirty-seven patients with primary nonresectable intrahepatic cholangiocarcinoma (57{\%} with prior treatment and/or metastasis) were prospectively treated with external radiation, chemotherapy, and 131I labelled anti-CEA. Therapy began in all trials with whole liver irradiation (21.0 Gy, 3.0 Gy/Fx, 4 days/week, 10 MV photons) with alternate treatment day chemotherapy (Adriamycin, 15 mg + 5-FU, 5011 mg). One month after external beam therapy, chemotherapy was given (Adriamycin,15 mg + 5-FU, 500 mg) followed the next day by the first administration of 131I anti-CEA. The treatment schedule used was 20 mCi day 0; 10 mCi day 5 as an outpatient. This schedule was derived from tumor dose estimates which indicated that 20 mCi (8-10 mCi/mg IgG) was sufficient to achieve tumor saturation with a tumor effective half-life of 3 to 5 days, depending upon the species of animal from which the antibody was obtained. The median tumor dose for the 20 mCi + 10 mCi regimen was 6.2 Gy. Antibody therapy was delivered in 2-month cycles using antibody generated in different species of animals; rabbit, pig, monkey, and bovine. Toxicity was limited to hematologic toxicity and was manifested as thrombocytopenia and leukocytopenia (3.2{\%} Grade IV for each according to RTOG toxicity criteria). Tumor remission evaluated by CT scan digitized tumor volume analysis indicated a 26.6{\%} partial response (PR). Tumor remission by physical examination indicated a 333{\%} remission rate (25.9{\%} PR and 7.4{\%} complete remission (CR)). The median survival for patients who responded was 15.2 months. The actuarial median survival for the entire group of patients (metastases and previous treatment) was 6.5 months. The longest partial remission is presently more than 4 years.",
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