Analysis of failure following curative irradiation of gallbladder and extrahepatic bile duct carcinoma

“…Treatment options for bile duct cancer remain limited due to the large number of patients with advanced disease at the time of diagnosis [5, 6, 7, 8, 9, 10]. Unresectable bile duct cancers are very difficult to treat with external beam radiotherapy (EBRT) alone due to the proximity of adjacent normal organs and the high doses required to effectively irradiating these neoplasms [2, 11, 12, 13].…”

Section: General Treatment Rulesmentioning

confidence: 99%

Brachytherapy in the treatment of bile duct cancer – a tough challenge

Skowronek¹,

Zwierzchowski²

2017

jcb

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The majority of patients with bile duct cancer are diagnosed with clinically advanced disease. Most of these patients have a short life expectancy and are treated with palliative aim. Most patients present with locally advanced or metastatic disease, which is not amenable to surgical resection, resulting in poor survival. Adjuvant or definitive radiotherapy, with or without chemotherapy, is therefore used in many centers worldwide for better local control, and with the expectation that it will have a favorable effect on survival. However, the lack of appropriate prospective trials, as well as the small size of the published series and their retrospective nature, has produced insufficient evidence for the best treatment for these patients. Intraluminal brachytherapy is an important component in the multimodality approach to bile duct cancers. The objective of this treatment is to deliver a high local dose of radiation to the tumor while sparing surrounding healthy tissues. The treatment can be safely adapted for right and left hepatic duct, and for common bile duct lesions. Brachytherapy plays a limited but specific role in definitive treatment with curative intent in selected cases of early disease, as well as in the postoperative treatment of small residual disease. Depending on the location of the lesion, in some cases, brachytherapy is a treatment of choice. Clinical indications, different techniques, results, and complications are discussed in this work.

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“…Die Ausbreitung in und entlang der Gallengangs wand macht diese Tumoren für eine intraluminale Strahlenthe rapie geeignet [6], Eine Metastasierung in den Leberhilus scheint uns nur dann eine Indikation für eine Radiotherapie, wenn nicht anderweitige therapieresistente Metastasen oder der Primärtumor den weiteren Krankhcitsverlauf bestimmen. Die Bestrahlung eines Gallenblasenkarzinoms (bei Fall 5 als primärer Gallengangstumor fehlgedeutet) läßt keinen thera peutischen Gewinn erhoffen [5], Vor Beginn einer Strahlentherapie muß der zytologische oder histologische Nachweis des malignen Tumors geführt werden [3,26] …”

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Kombinierte intraduktale und perkutane Radiotherapie bei maligner Gallenwegsobstruktion mit anschließender prothetischer Versorgung

Brambs¹,

Freund²,

Bruggmoser³

et al. 1987

Oncol Res Treat

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Die Strahlentherapie hat beim inoperablen malignen Verschlußikterus das Ziel, die Überlebenszeit gegenüber der palliativen Drainage zu verlängern. Bevorzugt wird eine Kombination einer intrakavitären Brachytherapie über eine perkutantranshepatische Drainage (30–40 Gy in 1 cm Abstand) mit einer perkutanen Pendelfeldbestrahlung (30–40 Gy). Diese Kombination erlaubt hohe lokale Tumordosen bei einem relativ großen Bestrahlungsvolumen. Nach Abschluß der Radiotherapie wird die PTD gegen eine dicklumige Prothese (14 F) ausgewechselt.

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Analysis of failure following curative irradiation of gallbladder and extrahepatic bile duct carcinoma

Cited by 85 publications

References 13 publications

Hepatic Resection in the Treatment of Hilar Cholangiocarcinoma

Hepatic Resection in the Treatment of Hilar Cholangiocarcinoma

Brachytherapy in the treatment of bile duct cancer – a tough challenge

Kombinierte intraduktale und perkutane Radiotherapie bei maligner Gallenwegsobstruktion mit anschließender prothetischer Versorgung

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