{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:19:25Z","timestamp":1787771965547,"version":"build-2784847793"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,10]]},"abstract":"\n Introduction:<\/jats:title>\n Chemotherapy (CT) is the standard of care in advanced gallbladder cancer (GBC). Should locally advanced GBC (LA-GBC) with response to CT and good performance status (PS) be offered as consolidation chemoradiation (cCTRT) to delay progression and improve survival There is a scarcity of literature on this approach in the English literature. We present our experience with this approach in LA-GBC.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n \n After obtaining ethics approval, we reviewed the records of consecutive GBC patients from 2014 to 2016. Out of 550 patients, 145 were LA-GBC who were initiated on chemotherapy. A contrast-enhanced computed tomography (CECT) abdomen was done to evaluate the response to treatment, according to the RECIST (Response Evaluation Criteria in Solid Tumors) criteria. All responders to CT (PR and SD) with good PS but unresectable were treated with cCTRT. Radiotherapy was given to GB bed, periportal, common hepatic, coeliac, superior mesenteric, and para-aortic lymph nodes up to a dose of 45 to 54 Gy in 25 to 28 fractions along with concurrent capecitabine at the rate of 1,250 mg\/m\n 2<\/jats:sup>\n . Treatment toxicity, overall survival (OS), and factors affecting OS were computed based on Kaplan\u2013Meier and Cox regression analysis.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The median age of patients was 50 years (interquartile range [IQR] = 43\u201356 years), and men to women ratio was 1:3. A total of 65% and 35% patients received CT and CT followed by cCTRT, respectively. The incidence of Grade 3 gastritis and diarrhea was 10% and 5%, respectively. Responses were partial response (PR; 65%), stable disease (SD; 12%), progressive disease (PD; 10%), and nonevaluable (NE; 13%) because they did not complete six cycles of CT or were lost to follow-up. Among PR, 10 patients underwent radical surgery (six after CT and four after cCTRT). At a median follow-up of 8 months, the median OS was 7 months with CT and 14 months with cCTRT (\n P<\/jats:italic>\n = 0.04). The median OS was 57 months, 12 months, 7 months, and 5 months for complete response (CR) (resected), PR\/SD, PD, and NE (\n P<\/jats:italic>\n = 0.008), respectively. OS was 10 months and 5 months for Karnofsky performance status (KPS) >80 and <80 (\n P<\/jats:italic>\n = 0.008), respectively. PS (hazard ratio [HR] = 0.5), stage (HR = 0.41), and response to treatment (HR = 0.05) were retained as independent prognostic factors.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n CT followed by cCTRT appears to improve survival in responders with good PS.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ijc.ijc_1145_20","type":"journal-article","created":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T06:29:05Z","timestamp":1712730545000},"page":"577-583","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":9,"title":["Consolidation chemoradiation (cCTRT) improves survival in responders to first-line chemotherapy (CT) in locally advanced gallbladder cancer (LA-GBC)"],"prefix":"10.4103","volume":"59","author":[{"given":"Mohammed N.","family":"Alam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sushma","family":"Agrawal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neeraj","family":"Rastogi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koilpillai Joseph","family":"Maria Das","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-23-20240828","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1002\/ijc.21683","article-title":"Gallbladder cancer worldwide: Geographical distribution and risk factors","volume":"118","author":"Randi","year":"2006","journal-title":"Int J Cancer"},{"key":"R2-23-20240828","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1056\/NEJMoa0908721","article-title":"Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer","volume":"362","author":"Valle","year":"2010","journal-title":"N Engl J Med"},{"key":"R3-23-20240828","doi-asserted-by":"crossref","first-page":"3009","DOI":"10.1245\/s10434-016-5197-0","article-title":"Neoadjuvant chemoradiation followed by surgery for locally advanced gallbladder cancers: A new paradigm","volume":"23","author":"Engineer","year":"2016","journal-title":"Ann Surg Oncol"},{"key":"R4-23-20240828","doi-asserted-by":"crossref","first-page":"2137","DOI":"10.7314\/APJCP.2016.17.4.2137","article-title":"Radiological downstaging with neoadjuvant therapy in unresectable gall bladder cancer cases","volume":"17","author":"Agrawal","year":"2016","journal-title":"Asian Pac J Cancer Prev"},{"key":"R5-23-20240828","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1016\/j.hpb.2018.03.008","article-title":"Outcome of neoadjuvant chemotherapy in \u201clocally advanced\/borderline resectable\u201d gallbladder cancer: The need to define indications","volume":"20","author":"Chaudhari","year":"2018","journal-title":"HPB (Oxford"},{"key":"R6-23-20240828","doi-asserted-by":"crossref","first-page":"368","DOI":"10.21037\/jgo.2017.03.08","article-title":"Treatment of advanced gall bladder cancer in the real world-can continuation chemotherapy improve outcomes?","volume":"8","author":"Ostwal","year":"2017","journal-title":"J Gastrointest Oncol"},{"key":"R7-23-20240828","doi-asserted-by":"crossref","first-page":"59","DOI":"10.6004\/jnccn.2017.7067","article-title":"Chemo-radiotherapy versus chemotherapy alone for un-resected non-metastatic gallbladder cancer: National practice patterns and outcomes","volume":"16","author":"Verma","year":"2018","journal-title":"J Natl Compr Canc Netw"},{"key":"R8-23-20240828","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1002\/cam4.975","article-title":"Does radiotherapy still have a role in unresected biliary tract cancer?","volume":"6","author":"Pollom","year":"2017","journal-title":"Cancer Med"},{"key":"R9-23-20240828","first-page":"496","article-title":"Primary carcinoma of the gallbladder: Role of external beam radiation therapy in patients with locally advanced tumor","volume":"172","author":"Uno","year":"1996","journal-title":"Strahlenther Onkol"},{"key":"R10-23-20240828","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.critrevonc.2013.10.007","article-title":"Chemoradiation and brachytherapy in extrahepatic bile duct carcinoma","volume":"90","author":"Mattiucci","year":"2014","journal-title":"Crit Rev Oncol Hematol"},{"key":"R11-23-20240828","first-page":"1784","article-title":"An atlas for clinical target volume definition, including elective nodal irradiation in definitive radiotherapy of biliary cancer","volume":"17","author":"Bisello","year":"2019","journal-title":"Oncol Lett"}],"container-title":["Indian Journal of Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijc.IJC_1145_20","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:22:06Z","timestamp":1787768526000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijc.IJC_1145_20"}},"subtitle":["A new standard of care?"],"short-title":[],"issued":{"date-parts":[[2022,10]]},"references-count":11,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.4103\/ijc.ijc_1145_20","relation":{},"ISSN":["0019-509X"],"issn-type":[{"value":"0019-509X","type":"print"}],"subject":[],"published":{"date-parts":[[2022,10]]}}}