The 9 MostNutty TRIB1 Tips... And The Way To Use Them

Given the low incidence of ICC, few studies have examined postoperative radiotherapy as a treatment option (20,21). The largest analysis to date is a retrospective study of 3,839 patients from 1973 to 2003 based on the Surveillance, Epidemiology, and End Results (SEER) database (21). Median OS was 11 months in contrast to 6 months (P=0.014) for ICC patients treated with surgery and radiotherapy versus surgery alone (21). However, information regarding radiation dose, radiation technique, and surgical characteristics (e.g., resection margin status) were not recorded. The longer survival observed in the present cohort compared to MK-2206 order the SEER report (21) is likely due to the utilization of IMRT, which allows effective doses of radiation to be delivered specifically to the tumor area while minimizing the volume of normal liver irradiated. Very few studies have examined the role of combined chemotherapy and radiotherapy in the postoperative setting in the treatment of ICC. A study by Serafini et al. (20) of 92 patients with either extrahepatic cholangiocarcinoma (ECC) or ICC demonstrated a survival benefit from chemoradiotherapy (CRT) in distal ECC patients compared to observational control (median OS, 41 vs. 21 months, P=0.04); a similar trend was observed for ICC patients, but was Ibrutinib purchase not statistically significant. Despite the uncertain role of adjuvant CRT in the treatment of ICC, more evidence exists to support its benefit in ECC. A single-institution, small retrospective study of 34 patients with adenocarcinoma of the distal bile duct treated with pancreaticoduodenectomy and adjuvant CRT (5-fluorouracil and external beam RT, median dose 50.4 Gy) showed improved survival compared to the historical control of surgery alone (median OS, 37 vs. 22 months, PTRIB1 R0 resection (medial OS, 32 vs. 31 months, P=0.59). Given the benefit of postoperative radiotherapy in ICC patients shown in this study and the reported effectiveness of adjuvant CRT in the treatment of ECC, more studies are needed to further investigate whether the addition of chemotherapy to postoperative radiotherapy has the potential to improve survival in ICC patients. There are a number of limitations in this report. As a retrospective study, patients were not randomized to the type of treatment. Patients with a satisfactory recovery from surgery may be unintentionally selected for radiotherapy treatment.