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J Korean Soc Ther Radiol > Volume 9(2); 1991 > Article
Journal of the Korean Society for Therapeutic Radiology 1991;9(2): 253-263.
The Role of Radiotherapy in the Treatment of Extrahepatic Bile Duct Carcinoma
Hyun Soo Shin, Gwi Eon Kim, Hyung Sik Lee, Chang Ok Suh, John J K Loh, Jong Tae Lee
1Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.
2Department of Radiology Yonsei University College of Medicine, Seoul, Korea.
Twenty-seven patients with unresectable extrahepatic bile duct carcinoma (n=21) or with microscopic evidence of tumor rest after aggressive surgery for extrahepatic bile duct carcinoma(n=6) between 1985 and 1990 were given radiotherapy consisting intentionally external radiotherapy and /or intraluminal therapy using Gamma-Med 12i (192-lr) high dose rate (HDR) remote control afterloading system following bile drainage procedures and Gianturco stent insertion. The objectives of this study has been to assess the feasibility and effects on survival of a combination of external radiotherapy and brachytherapy with which we hope to achieve optimal loco-regional control for patients with unresectable extrahepatic bile duct tumors. Sixteen patients were men and deleven were women, and the mean age was 58 years (34-70). 10MV X-ray was used for radiation therapy, with the total dose ranging from 45 Gy to 55 Gy, and intraluminal brachytherapy performed after external radiotherapy, with the dose of total 15 Gy. The minimum follow up was 12 months. Failure were predominantly local-regional, without distant failure. Median survival was 10 months; 2-year actuarial survival rates was 21%. Median survival for common hepatic duct(CHD) cancer was 9 months; for common bile duct (CBD) cancer, was 16 months. And median survival for incomplete surgery/external radiotherapy group and external/intraluminal radiotherapy group was 10 months; for external radiotherapy alone group, was 6 months. Use of chemotherapy and/or hyperthermia were not affected in survival. Therefore, our result is that the survival rates in the group of external/intralumial radiotherapy were comparable with ones in the group of incomplete resection/external radiotherapy, andso we believe that the aggressive local and regional radiotherapy can improve the quality of life and the survival length
Key Words: Extrahepatic bile duct tumors, intraluminal brachytherapy
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