UNASSIGNED: e14626 Background: Unresectable @entity201 is commonly treated with @entity136 -based chemotherapy. Consolidative radiotherapy (RT) is increasingly being used for @entity1 with @entity66 . @entity253 and @entity255 are important causes of morbidity and mortality in @entity201 . The impact of MMT vs. chemotherapy alone on survival and biliary obstruction has not yet been characterized. METHODS: Using the MD Anderson @entity5 registry, we identified 137 @entity1 with @entity201 from 1998-2009 and retrospectively reviewed their records for demographic, epidemiologic, and treatment data. We performed analyses of @entity1349 ( @entity1349 ) using the Kaplan-Meier method with stratification by extent of disease (locally advanced vs. metastatic). We used the Pearson chi-square test to analyze the impact of RT on measures of disease-related morbidity. RESULTS: The median @entity1349 of the entire group was 48 weeks. 64% of @entity1 had locally advanced disease and 71% received at least one line of therapy. @entity1 receiving first-line @entity136 plus @entity900 (n=42) had a superior @entity1349 when compared to those receiving other first-line therapies (n=55; 71 weeks vs. 50 weeks, p=0.02). There was no significant improvement in @entity1349 in those @entity1 who received RT (n=48) vs. those who never received RT (n=49; 58 weeks vs. 54 weeks, p=0.96). However, @entity1349 with consolidative RT (n=13) was 113 weeks vs. 70 weeks with chemotherapy alone (n=29) [p=0.11]. RT did not significantly reduce the morbidity of @entity201 , including non-elective biliary stent exchanges (p=0.79), admissions for obstructive @entity1087 or @entity255 (p=0.57), and non-elective, cancer-related admissions (p=0.69). CONCLUSIONS: This series of @entity201 @entity1 confirms the previously reported survival improvement with @entity136 plus @entity900 in the first-line setting for bile duct @entity5 . The role of RT in reducing biliary complications from @entity201 remains unclear. Consolidative RT may increase survival in selected @entity1 compared to chemotherapy alone, although this requires further investigation in prospective, randomized clinical trials.

The role of multimodality therapy (MMT) in @entity201 ( XXXX ).

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity66 :: ('MESH:D004194', 'Disease') :: ['localized disease'] @entity1087 :: ('MESH:D007565', 'Disease') :: ['jaundice'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'tumors'] @entity900 :: ('MESH:D002945', 'Chemical') :: ['cisplatin'] @entity201 :: ('MESH:D018281', 'Disease') :: ['UHC', 'hilar cholangiocarcinoma'] @entity253 :: ('MESH:D001660', 'Disease') :: ['Biliary obstruction'] @entity136 :: ('MESH:C056507', 'Chemical') :: ['gemcitabine'] @entity255 :: ('MESH:D002761', 'Disease') :: ['cholangitis'] @entity1349 :: ('MESH:D011475', 'Disease') :: ['OS', 'overall survival']
@entity201 :: (MESH:D018281,Disease) :: ['UHC']
