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. 1991 Jul 15;68(2):289-94.
doi: 10.1002/1097-0142(19910715)68:2<289::aid-cncr2820680213>3.0.co;2-2.

Radiation therapy for primary carcinoma of the extrahepatic biliary system. An analysis of 63 cases

J C Flickinger  1 , A H Epstein, S Iwatsuki, B I Carr, T E Starzl
Affiliations

Radiation therapy for primary carcinoma of the extrahepatic biliary system. An analysis of 63 cases

J C Flickinger et al. Cancer. .

Abstract

From 1976 to 1988, 63 patients received radiation therapy for primary cancers of the extrahepatic biliary system (eight gallbladder and 55 extrahepatic biliary duct). Twelve patients underwent orthotopic liver transplantation. Chemotherapy was administered to 13 patients. Three patients underwent intraluminal brachytherapy alone (range, 28 to 55 Gy). Sixty patients received megavoltage external-beam radiation therapy (range, 5.4 to 61.6 Gy; median, 45 Gy), of whom nine received additional intraluminal brachytherapy (range, 14 to 45 Gy; median, 30 Gy). The median survival of all patients was 7 months. Sixty patients died, all within 39 months of radiation therapy. One patient is alive 11 months after irradiation without surgical resection, and two are alive 50 months after liver transplantation and irradiation. Symptomatic duodenal ulcers developed after radiation therapy in seven patients but were not significantly related to any clinical variable tested. Extrahepatic biliary duct cancers, the absence of metastases, increasing calendar year of treatment, and liver transplantation with postoperative radiation therapy were factors significantly associated with improved survival.

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Figures

Fig. 1
Fig. 1
Actuarial survival of all patients receiving radiation therapy for cholangiocarcinoma (n = 63). Numbers in parentheses indicate the number of patients at risk.
Fig. 2
Fig. 2
Actuarial survival of patients with gallbladder primaries (n = 8) compared with patients with extrahepatic biliary duct primaries (n = 55). Numbers in parentheses indicate the number of patients at risk.
Fig. 3
Fig. 3
Actuarial survival of patients undergoing liver transplantation with preoperative or postoperative radiation therapy (n = 9) compared with patients receiving more conservative therapy (n = 54). Numbers in parentheses indicate the number of patients at risk.
Fig. 4
Fig. 4
Actuarial survival for freedom from symptomatic duodenal ulcers (n = 63). Numbers in parentheses indicate the number of patients at risk.
See this image and copyright information in PMC

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