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. 2019 May 20;39(Suppl Suppl 1):143–155. doi: 10.1111/liv.14089

Table 1.

Mayo clinic protocol

Mayo clinic protocol External beam radiation therapy (45 Gy in 30 fractions, 1.5 Gy twice daily)
Brachytherapy (20 Gy at 1 cm in approximately 20‐25 h) – administered 2 wks following completion of external beam radiation therapy
Capecitabine – administered until the time of transplantation, held during perioperative period for staging
Abdominal exploration for staging – as time nears for deceased donor transplantation or day prior to living donor transplantation
Liver transplantation
Inclusion criteria Diagnosis of pCCA (transcatheter biopsy or brush cytology, CA 19‐9 > 100 mg/mL and/or a mass on cross‐sectional imaging with a malignant appearing stricture on cholangiography)
Unresectable tumour above cystic duct (pancreatoduodenectomy for microscopic involvement of CBD, resectable pCCA arising in PSC)
Radial tumour diameter 3 cm
Absence of intrahepatic and extrahepatic metastases
Candidate for liver transplantation
Exclusion criteria Intrahepatic cholangiocarcinoma
Uncontrolled infection
Prior radiation or chemotherapy
Prior biliary resection or attempt resection
Intrahepatic metastases
Evidence of extrahepatic disease
History of other malignancy within 5 years
Transperitoneal biopsy (including percutaneous and EUS‐guided FNA)