Intraoperative radiotherapy for resectable extrahepatic bile duct cancer

Kurosaki, Hiromasa; Kiura, Katsuyuki; Kaizu, Toshihide; Matsuda, Tadayoshi; Okamoto, Akira; Sato, Takako; Ebara, Takeshi; Tanaka, Yoshiaki

doi:10.1016/s0360-3016(99)00248-5

Cited by 11 publications

(6 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…IORT related complications on the biliary system were previously reported in clinical investigations [9,12]. Gastrointestinal bleeding, hepatic abscess, septicemia, stenosis, or obstruction of anastomoses had been found in clinical practice.…”

Section: Discussionmentioning

confidence: 89%

“…Gastrointestinal bleeding, hepatic abscess, septicemia, stenosis, or obstruction of anastomoses had been found in clinical practice. Necrosis of the biliary tree wall after IORT was detected at the postmortem examination and reported in one patient by Kurosaki and colleagues [12]. Iwasaki and coworkers published the death of four patients after IORT of the biliary tract [9].…”

Section: Discussionmentioning

confidence: 94%

“…Although IORT has been proved to be benificial to patients with bile-duct carcinoma, IORTrelated complications were reported [9][10][11][12][13]. Up to now, experimental data concerning normal tissue tolerance to IORT have been generated in dogs [6,[14][15][16][17][18][19].…”

Section: Original Researchmentioning

confidence: 99%

See 2 more Smart Citations

Biliodigestive Anastomosis After Intraoperative Irradiation in Swine

Kaiser

Mueller

Sauerwein

et al. 2005

Journal of Investigative Surgery

View full text Add to dashboard Cite

A large animal model was established to investigate the feasibility and suitable dosage of intraoperative radiation therapy (IORT) to the hepatic hilum before biliary-enteric anastomosis is performed. Twenty-two Pietrain Hampshire pigs underwent gallbladder and proximal bile duct resection followed by IORT using 20-40 Gy and performing biliary-enteric anastomosis. In the follow-up period of 56 days, pigs developed dose-dependent complications like stenosis of the biliary-enteric anastomosis. Results demonstrate that IORT of the liver hilum up to 20 Gy is safe with acceptable early complications in the presented animal model. The porcine biliary-enteric anastomosis can tolerate intraoperative irradiation up to a dosage of 40 Gy without disruption.

show abstract

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 94%

See 1 more Smart Citation

Biliodigestive Anastomosis After Intraoperative Irradiation in Swine

Kaiser

Mueller

Sauerwein

et al. 2005

Journal of Investigative Surgery

View full text Add to dashboard Cite

show abstract

“…This group could show that IORT of up to 20Gy is relatively safe with acceptable complications [8]. In a human setting, complications after IORT of the biliary system were reported [9,21]. For example, Iwasaki et al [9] reported the death of four patients due to IORT-associated complications like gastrointestinal bleeding, hepatic abscess or septicaemia, and by the tumor itself applying more than 20Gy of IORT.…”

Section: Iort Of the Liver Hilum 167mentioning

confidence: 99%

Vascular and Nerval Damage After Intraoperative Radiation Therapy of the Liver Hilum in a Large Animal Model

Juntermanns¹,

Grabellus²,

Zhang³

et al. 2013

Journal of Investigative Surgery

View full text Add to dashboard Cite

It has been demonstrated that intraoperative radiotherapy is a therapeutic option for patients suffering from perihilar cholangiocarcinoma. Aim of our study was to investigate vascular and nerve damages after irradiation of the liver hilum in a pig model. Twenty-four pigs underwent central bile duct resection followed by biliodigestive anastomosis. Nine pigs underwent this surgical procedure alone (group 1). Ten pigs were treated with additional intraoperative radiation therapy (IORT) of 20Gy to the liver hilum (group 2). And five pigs received operation and IORT with 40Gy to the area of anastomosis (group 3). Six weeks after operation and treatment the animals were sacrificed and histopathological examination was performed. Histology showed no vascular or nerve damage in non-irradiated perihilar tissue. Significant changes of nerve structures occurred, as well as vascular damage in large and even more in small hilar arteries in the irradiated neighboring liver tissue. In detail for small hilar arteries: intima proliferation (p ≤ .0001), endothelial swelling (p ≤ .0001), fibrinoid arterial wall necrosis (p ≤ .0001), and arterial thrombosis (p = .0079) were detected. Venous vessels did not show significant dose dependant cell damage. Overall, 20Gy as a single dose application during operation showed similar damage to vessels and nerves compared to 40Gy. A radiation dosage of 20Gy seems to be sufficient to induce necrosis due to vascular and nerve damage in potential malignant liver tissue with acceptable damage to surrounding tissue. Perineural invaded tumor cells might be diminished due to IORT.

show abstract

“…Therefore, treatment with ILBT only has been used restrictively in small carcinomas that do not spread beyond the extrahepatic bile duct. 11 However, the effect of combination of EBRT with ILBT remains controversial. Shin et al 9 reported that combined use of EBRT and ILBT is an effective method for improving the treatment outcome in patients with inoperable carcinoma of the extrahepatic bile ducts.…”

mentioning

confidence: 99%

The Efficacy of Intraluminal Brachytherapy as Palliative Therapy of Hilar Cholangiocarcinoma

Park

Jeong²,

Kim³

et al. 2015

Korean J Pancreas Biliary Tract

View full text Add to dashboard Cite

Cholangiocarcinoma is the primary malignant tumor of the bile ducts which originates from cholangiocytes. 1 Surgical resection is the only curative therapy. Unfortunately, due to lack of symptoms until late in the disease, the majority of patients present with unresectable disease, typically resulting in advanced cholangiocarcinoma at the time of diagnosis. In addition, advanced age, poor performance status, acute illness, and/or systemic disease are considered inoperable in many cases. 2,3 In particular, in hilar cholangiocarcinoma, primary invasion of the portal vein and metastasis to the hepatic lobes occurs so frequently that surgical resection is impossible, and it is associated with a poor prognosis. 4 Biliary

show abstract

Intraoperative radiotherapy for resectable extrahepatic bile duct cancer

Cited by 11 publications

References 17 publications

Biliodigestive Anastomosis After Intraoperative Irradiation in Swine

Biliodigestive Anastomosis After Intraoperative Irradiation in Swine

Vascular and Nerval Damage After Intraoperative Radiation Therapy of the Liver Hilum in a Large Animal Model

The Efficacy of Intraluminal Brachytherapy as Palliative Therapy of Hilar Cholangiocarcinoma

Contact Info

Product

Resources

About