Reviewing the potential role of radiation therapy in gallbladder cancer: an update

Abstract

The gallbladder is a small pear-shaped organ that lies underneath the liver and stores bile. Despite being a small organ there is a high chance of malignancy reported. The absence of the serosa layer, proximity to critical adjoining structures, and easy extension to lymphatics makes it vulnerable for early dissemination. Often, patients present in an advanced stage of the disease, with disseminated metastasis being reported in the range of 65% to 82%, for hematological metastasis and 91% to 94% for lymphatic metastasis, respectively [1,2]. Although its incidence in Western countries is less, it is quite prevalent in Asian counties with a high prevalence seen amongst obese females with a personal or family history of gallstones and ill-defined genetic variants [3]. According to GLOB-OCAN 2020 data [4], gallbladder cancer (GBC) is the 23rd most incident but 20th most deadly cancer worldwide.Depending upon the stage of the disease, surgery, radiotherapy (RT), and chemotherapy are the modalities of treatment used for Gallbladder cancer is a highly malignant disease with a poor prognosis. It is the most common cancer of the biliary tract pathway. Although surgery remains the treatment of choice for early-stage disease, majority of the patients presents in locally advanced, unresectable and metastatic stage of the disease. Radiotherapy and chemotherapy thus form an integral part of management for these locally advanced staged patients. The role of radiation though has been advocated in gallbladder cancer, majorly in the adjuvant setting, its role in neoadjuvant and palliative settings remains in an evolving phase. The article thus aims to review and update the existing literature regarding the role of radiation therapy in gallbladder cancer.

"Assessment of Target Volume Definition for Precise Radiotherapeutic Management of Locally Recurrent Biliary Tract Cancers: An Original Research Article"

“…While extrahepatic cancers originate from similar epithelia, the etiology may differ owing to their anatomy. Although comprising a small proportion of all cancers, BTC accounts for the second most frequent hepatic malignancy after hepatocellular carcinomas [1][2][3][4][5].…”

“…Although the gallbladder is a small organ, it may be associated with cancer. There may be predilection for early spread with resultant grim prognosis partly due to the lack of serosa layer and close proximity to critical surrounding structures along with extension to lymphatics [1][2][3][4][5].…”

“…Patients with BTC may be diagnosed at relatively advanced disease stages, and symptoms may profoundly deteriorate quality of life. In the meantime, multidisciplinary management may be used to achieve improved treatment results [2][3][4][5][6][7][8][9][10]. RT may play a critical role in definitive, adjuvant, or palliative setting and also for management of recurrent BTC.…”

“…Currently, multidisciplinary management may be utilized for achieving optimal therapeutic outcomes [2][3][4][5][6][7][8][9][10]. Radiation therapy (RT) may play a role in definitive, adjuvant, or palliative setting and also for management of recurrent disease.…”

Analysis of the efficacy and factors influencing survival of adjuvant radiotherapy for stage II-III biliary tract carcinoma

“…Currently, surgical resection is the mainstay of treatment for biliary tract carcinoma, but the high recurrence rate and low survival rate after surgery mean that adjuvant chemotherapy and radiotherapy are required to improve patient survival [ 3 ]. In recent years, researchers [ 4 – 6 ] have focused on the necessity and efficacy of adjuvant radiotherapy for biliary tract carcinoma. In the present study, we retrospectively reviewed the data of 37 postoperative patients with biliary tract carcinoma from our hospital in order to (i) determine whether postoperative adjuvant radiotherapy was associated with improvements in survival time and survival rate, and (ii) identify the factors affecting patient prognosis and survival after radical surgery for biliary tract carcinoma.…”