title: Analysis of failure after curative irradiation of extrahepatic bile duct carcinoma.
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.
authors.affiliation: Section of Radiation Oncology, Mayo Clinic, Jacksonville, FL 32224.
authors.forename: S J
authors.initials: SJ
authors.lastname: Buskirk
authors.forename: L L
authors.initials: LL
authors.lastname: Gunderson
authors.forename: S E
authors.initials: SE
authors.lastname: Schild
authors.forename: C E
authors.initials: CE
authors.lastname: Bender
authors.forename: H J
authors.initials: HJ
authors.lastname: Williams
authors.forename: D C
authors.initials: DC
authors.lastname: McIlrath
authors.forename: J S
authors.initials: JS
authors.lastname: Robinow
authors.forename: W J
authors.initials: WJ
authors.lastname: Tremaine
authors.forename: J K
authors.initials: JK
authors.lastname: Martin
mesh_terms: D002759:Adenoma, Bile Duct / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D005472:Fluorouracil