title: Intraoperative radiation therapy for biliary tract carcinoma: results of a 5-year experience.
abstract: The results of a 5-year experience with use of intraoperative radiation therapy (IORT) in the management of locally advanced bile duct carcinoma are presented. Fifteen patients received IORT doses between 5 and 20 Gy for localized disease, which was either primary and resected with microscopic residual (2 patients), primary and unresected (10 patients), or recurrent (3 patients). Thirteen patients also received postoperative radiation therapy. The median survival of the 12 patients with primary disease was 14 months, with disease controlled in the porta hepatis in 5 of 10 evaluable patients. The three patients with recurrent disease survived 2, 9, and 11 months. There were two operative deaths, for an operative mortality of 13%. Acute and chronic complications are reviewed. Cholangitis is the most frequent in both categories. This aggressive approach in the therapy for advanced disease has an acceptable level of morbidity and may warrant the use of IORT as part of the management of biliary tract cancer.
authors.affiliation: Department of Radiation Therapy, New England Deaconess Hospital, Boston, Mass.
authors.forename: P M
authors.initials: PM
authors.lastname: Busse
authors.forename: M D
authors.initials: MD
authors.lastname: Stone
authors.forename: T A
authors.initials: TA
authors.lastname: Sheldon
authors.forename: J T
authors.initials: JT
authors.lastname: Chaffey
authors.forename: B
authors.initials: B
authors.lastname: Cady
authors.forename: W V
authors.initials: WV
authors.lastname: McDermott
authors.forename: A
authors.initials: A
authors.lastname: Bothe
authors.forename: R
authors.initials: R
authors.lastname: Jenkins
authors.forename: G
authors.initials: G
authors.lastname: Steele
mesh_terms: D000208:Acute Disease; D000230:Adenocarcinoma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D000328:Adult; D000368:Aged; D001661:Biliary Tract Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D002761:Cholangitis / Q000150:complications; D002908:Chronic Disease; D003131:Combined Modality Therapy; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D010865:Pilot Projects; D011832:Radiation Injuries / Q000209:etiology; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D012720:Severity of Illness Index