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Annals of Surgery logoLink to Annals of Surgery
. 1992 Feb;215(2):125–131. doi: 10.1097/00000658-199202000-00006

Analysis of failure after curative irradiation of extrahepatic bile duct carcinoma.

S J Buskirk 1, L L Gunderson 1, S E Schild 1, C E Bender 1, H J Williams Jr 1, D C McIlrath 1, J S Robinow 1, W J Tremaine 1, J K Martin Jr 1
PMCID: PMC1242399  PMID: 1312319

Abstract

Thirty-four patients with subtotally resected or unresectable carcinoma of the extrahepatic bile ducts received radiation therapy; a minimum of 45 Gy (external beam) to the tumor and regional lymph nodes +/- 5-fluorouracil (5-FU). Seventeen patients received an external beam boost of 5 to 15 Gy to the tumor, and a specialized boost was used in the remaining 17 patients (iridium-192 transcatheter seeds in 10 and intraoperative radiation therapy [IORT] with electrons in seven). The median time to death in all 34 patients was 12 months (range, 4 to 98-months). The only patients who survived longer than 18 months were those either with gross total or subtotal resection before external irradiation (2 of 6) or who received specialized boosts (192Ir, 3 of 10; IORT, 3 of 7). Local failure was documented in 9 of 17 patients who received external beam irradiation alone +/- 5-FU, 3 of 10 patients who received an 192Ir boost, and 2 of 6 patients who received an IORT boost with curative intent.

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Selected References

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  1. Bismuth H., Malt R. A. Current concepts in cancer: carcinoma of the biliary tract. N Engl J Med. 1979 Sep 27;301(13):704–706. doi: 10.1056/NEJM197909273011307. [DOI] [PubMed] [Google Scholar]
  2. Buskirk S. J., Gunderson L. L., Adson M. A., Martinez A., May G. R., McIlrath D. C., Nagorney D. M., Edmundson G. K., Bender C. E., Martin J. K., Jr Analysis of failure following curative irradiation of gallbladder and extrahepatic bile duct carcinoma. Int J Radiat Oncol Biol Phys. 1984 Nov;10(11):2013–2023. doi: 10.1016/0360-3016(84)90198-6. [DOI] [PubMed] [Google Scholar]
  3. Fletcher G. H. Clinical dose-response curves of human malignant epithelial tumours. Br J Radiol. 1973 Jan;46(541):1–12. doi: 10.1259/0007-1285-46-541-1. [DOI] [PubMed] [Google Scholar]
  4. Fletcher G. H., Shukovsky L. J. The interplay of radiocurability and tolerance in the irradiation of human cancers. J Radiol Electrol Med Nucl. 1975 May;56(5):383–400. [PubMed] [Google Scholar]
  5. Green N., Mikkelsen W. P., Kernen J. A. Cancer of the common hepatic bile ducts--palliative radiotherapy. Radiology. 1973 Dec;109(3):687–689. doi: 10.1148/109.3.687. [DOI] [PubMed] [Google Scholar]
  6. Hashmonai M., Lev L., Schramek A., Ben-Arieh Y., Robinson E. Long survival following combined treatment of inoperable cholangiocarcinoma: surgery, radiotherapy, and chemotherapy. J Surg Oncol. 1980;13(3):231–235. doi: 10.1002/jso.2930130308. [DOI] [PubMed] [Google Scholar]
  7. Kopelson G., Galdabini J., Warshaw A. L., Gunderson L. L. Patterns of failure after curative surgery for extra-hepatic biliary tract carcinoma: implications for adjuvant therapy. Int J Radiat Oncol Biol Phys. 1981 Mar;7(3):413–417. doi: 10.1016/0360-3016(81)90118-8. [DOI] [PubMed] [Google Scholar]
  8. Kopelson G., Harisiadis L., Tretter P., Chang C. H. The role of radiation therapy in cancer of the extra-hepatic biliary system: an analysis of thirteen patients and a review of the literature of the effectiveness of surgery, chemotherapy and radiotherapy. Int J Radiat Oncol Biol Phys. 1977 Sep-Oct;2(9-10):883–894. doi: 10.1016/0360-3016(77)90186-9. [DOI] [PubMed] [Google Scholar]
  9. Lokich J. J., Kane R. A., Harrison D. A., McDermott W. V. Biliary tract obstruction secondary to cancer: management guidelines and selected literature review. J Clin Oncol. 1987 Jun;5(6):969–981. doi: 10.1200/JCO.1987.5.6.969. [DOI] [PubMed] [Google Scholar]
  10. MacCarty R. L. Nonsurgical management of obstructive jaundice in the patient with advanced cancer. JAMA. 1980 Oct 24;244(17):1976–1978. [PubMed] [Google Scholar]
  11. Martenson J. A., Jr, Gunderson L. L., Buskirk S. J., Nagorney D. M., Martin J. K., May G. R., Bender C. E., Tremaine W. J. Hepatic duct stricture after radical radiation therapy for biliary cancer: recurrence or fibrosis? Mayo Clin Proc. 1986 Jul;61(7):530–536. doi: 10.1016/s0025-6196(12)62000-x. [DOI] [PubMed] [Google Scholar]
  12. POWERS W. E., TOLMACH L. J. PRE-OPERATIVE RADIATION THERAPY: BIOLOGICAL BASIS AND EXPERIMENTAL INVESTIGATION. Nature. 1964 Jan 18;201:272–273. doi: 10.1038/201272a0. [DOI] [PubMed] [Google Scholar]
  13. Palos B. B., Pooler D., Goffinet D. R., Martinez A. A method for inserting I-125 seeds into absorbable sutures for permanent implantation in tissue. Int J Radiat Oncol Biol Phys. 1980 Mar;6(3):381–386. doi: 10.1016/0360-3016(80)90156-x. [DOI] [PubMed] [Google Scholar]
  14. Rider W. D., Palmer J. A., Mahoney L. J., Robertson C. T. Preoperative irradiation in operable cancer of the rectum: report of the Toronto trial. Can J Surg. 1977 Jul;20(4):335–338. [PubMed] [Google Scholar]
  15. Sindelar W. F., Tepper J., Travis E. L. Tolerance of bile duct to intraoperative irradiation. Surgery. 1982 Sep;92(3):533–540. [PubMed] [Google Scholar]
  16. Warren K. W., Mountain J. C., Lloyd-Jones W. Malignant tumours of the bile-ducts. Br J Surg. 1972 Jul;59(7):501–505. doi: 10.1002/bjs.1800590702. [DOI] [PubMed] [Google Scholar]

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