Definitive radiation therapy for extrahepatic bile duct carcinoma.
OBJECTIVE
To evaluate retrospectively the role of radiation therapy for extrahepatic bile duct (EHBD) carcinoma.


METHODS
Twenty-seven patients with local-regional EHBD carcinomas were treated with definitive radiation therapy. Radiation therapy was delivered by means of external beam radiation therapy (EBRT) alone or combined with transcatheter iridium-192 brachytherapy. The median total dose was 54 Gy (range, 30-144 Gy). Survival rates were calculated and compared by using the log-rank test. Possible prognostic factors affecting survival were evaluated by means of univariate analysis.


RESULTS
The median survival of all patients was 13 months, with 1- and 2-year actuarial survival rates of 52% and 10%, respectively. Univariate analysis revealed that men, patients with tumors limited to the bile duct, and patients receiving EBRT doses of at least 45 Gy had significantly better outcomes. Local-regional recurrence was the main cause of treatment failure (82%). Two patients developed gastric outlet obstruction.


CONCLUSIONS
Patients with locally advanced EHBD carcinomas have a low survival rate. Certain factors, however, appear to have prognostic significance.
Tsujino
K
K
Department of Radiation Oncology, Emory University College of Medicine, Atlanta, Ga, USA.
Landry
J C
JC
Smith
R G
RG
Keller
J W
JW
Williams
W H
WH
Davis
L W
LW
D000230:Adenocarcinoma / Q000401:mortality / Q000532:radiotherapy*; D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D017734:Bile Ducts, Extrahepatic; D001918:Brachytherapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D015996:Survival Rate