{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T08:43:00Z","timestamp":1792312980111,"version":"4.4.0"},"reference-count":37,"publisher":"Wiley","issue":"23","license":[{"start":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T00:00:00Z","timestamp":1733788800000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>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\u2009months. However, international guidelines still consider concurrent chemoradiation (CRT) as an alternative treatment option. This study aims to review the current evidence on \u201cmodern\u201d CRT for primary or recurrent unresectable BTC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>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 non\u2010metastatic, primary, or recurrent BTC were included. Only English\u2010written papers published between January 2010 and June 2022 were considered.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seventeen papers, comprising a total of 1961 patients, were included in the analysis. Among them, 11 papers focused solely on patients with primary 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\u2009Gy (range: 45.0\u201372.6\u2009Gy) using conventional fractionation. Concurrent CHT primarily consisted of 5\u2010Fluorouracil or Gemcitabine. The pooled rates of 1\u2010year progression\u2010free survival (PFS) and OS were 40.9% and 56.2%, respectively. The median 1\u2010 and 2\u2010year OS rates were 63.1% and 29.4%, respectively. Grade \u22653 acute gastrointestinal toxicity ranged from 5.6% to 22.2% (median: 10.9%), while grade\u2009\u22653 hematological toxicity ranged from 1.6% to 50.0% (median: 21.7%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Concurrent CRT is a viable alternative to standard CHT in patients with locally advanced BTC, offering comparable OS and PFS rates, along with an acceptable toxicity profile. However, prospective trials are needed to validate and further explore these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.70196","type":"journal-article","created":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T02:12:35Z","timestamp":1733883155000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Chemoradiation of locally advanced biliary cancer: A\n                    <scp>PRISMA<\/scp>\n                    \u2010compliant systematic review"],"prefix":"10.1002","volume":"13","author":[{"given":"Silvia","family":"Bisello","sequence":"first","affiliation":[{"name":"Radiation Oncology AOU delle Marche  Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Malizia","sequence":"additional","affiliation":[{"name":"Nuclear Medicine IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Mammini","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences (DIMEC) Alma Mater Studiorum \u2010 Bologna University  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5202-3472","authenticated-orcid":false,"given":"Erika","family":"Galietta","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences (DIMEC) Alma Mater Studiorum \u2010 Bologna University  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Medici","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences (DIMEC) Alma Mater Studiorum \u2010 Bologna University  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gian Carlo","family":"Mattiucci","sequence":"additional","affiliation":[{"name":"UOC Radioterapia Oncologica Mater Olbia Hospital  Olbia Italy"},{"name":"Dipartimento Universitario Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Cellini","sequence":"additional","affiliation":[{"name":"Dipartimento Universitario Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"},{"name":"Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia Fondazione Policlinico Universitario \u201cA. Gemelli\u201d IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Palloni","sequence":"additional","affiliation":[{"name":"Medical Oncology IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Tagliaferri","sequence":"additional","affiliation":[{"name":"Dipartimento di Diagnostica per Immagini, U.O.C. Radioterapia Oncologica, Radioterapia Oncologica Ed Ematologia Fondazione Policlinico Universitario Agostino Gemelli IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Macchia","sequence":"additional","affiliation":[{"name":"Radiation Oncology Unit Gemelli Molise Hospital\u2010Universit\u00e0 Cattolica del Sacro Cuore  Campobasso Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Deodato","sequence":"additional","affiliation":[{"name":"Dipartimento di Diagnostica per Immagini, U.O.C. Radioterapia Oncologica, Radioterapia Oncologica Ed Ematologia Fondazione Policlinico Universitario Agostino Gemelli IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Savino","family":"Cilla","sequence":"additional","affiliation":[{"name":"Medical Physics Unit Gemelli Molise Hospital  Campobasso Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Brandi","sequence":"additional","affiliation":[{"name":"Medical Oncology IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Arcelli","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences (DIMEC) Alma Mater Studiorum \u2010 Bologna University  Bologna Italy"},{"name":"Radiation Oncology IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessio G.","family":"Morganti","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences (DIMEC) Alma Mater Studiorum \u2010 Bologna University  Bologna Italy"},{"name":"Radiation Oncology IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.2147\/CMAR.S157092"},{"key":"e_1_2_10_3_1","first-page":"26","article-title":"Bile duct cancer early detection, diagnosis, and staging","author":"The American Cancer Society medical and editorial content team","year":"2018","journal-title":"CancerOrg"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0908721"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdz402"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(21)00171-0"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2022.100503"},{"key":"e_1_2_10_8_1","unstructured":"NCCN guidelines hepatobiliary cancers.NCCN Clinical Practice Guidelines in Oncology\u2014hepatobiliary cancers. Version 1.2022 2021."},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.21873\/anticanres.13445"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2020.604387"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.21037\/JGO-20-245"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/COC.0000000000000646"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2018.9774"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/1754-9485.12937"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2407-13-568"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20170308"},{"key":"e_1_2_10_17_1","unstructured":"PROSPERO.International prospective register of systematic reviews. Available at:https:\/\/www.crd.york.ac.uk\/PROSPERO."},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.5195\/jmla.2018.345"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.1411"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00280-016-3143-2"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.5754\/hge13076"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2014.08.013"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00066-012-0099-y"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2014.01.003"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00280-013-2340-5"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.21037\/jgo-21-615"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0253285"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctro.2019.07.007"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2017.7067"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.21037\/jgo.2018.01.15"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/PPO.0000000000000213"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2018.09.010"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2008.10.026"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.21037\/tcr-23-1763"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1056\/EVIDoa2200015"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)00727-4"}],"container-title":["Cancer Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.70196","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T04:53:47Z","timestamp":1739940827000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cam4.70196"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12]]},"references-count":37,"journal-issue":{"issue":"23","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1002\/cam4.70196"],"URL":"https:\/\/doi.org\/10.1002\/cam4.70196","archive":["Portico"],"relation":{},"ISSN":["2045-7634","2045-7634"],"issn-type":[{"value":"2045-7634","type":"print"},{"value":"2045-7634","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12]]},"assertion":[{"value":"2023-12-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70196"}}