Primary carcinoma of the gallbladder: role of external beam radiation therapy in patients with locally advanced tumor.
OBJECTIVE
Several reports have demonstrated that occasional long-term survival might be obtained with external beam radiation therapy in patients with gallbladder cancer. However, there are few reports which evaluate the local effect of irradiation. The aim of our study was to investigate the local effect of radiation therapy. and to evaluate its role for locally advanced gallbladder cancer.


METHODS
Twenty-two patients with locally advanced gallbladder cancer were treated with high-dose external beam radiation therapy. Tumor resection was performed in 5 patients, palliative surgery in 5, and the remaining 12 patients were treated by radiation therapy alone.


RESULTS
Overall survival was 36% at 1 year, 18% at 3 years and 14% at 5 years. All but 2 patients developed local recurrence and died of disease at 1 to 99 months after radiation therapy. Among 17 patients who had not undergone tumor resection, partial response was obtained in 4 patients and no response in 13. Survival times in patients who achieved partial response were 14, 26, 47 and 99 months, whereas those of no response were 1 to 12 months with a mean of 4.8 months. Survival between these 2 groups (partial vs. no response) showed significant difference (p = 0.0008, logrank test).


CONCLUSIONS
It is concluded that high-dose external beam radiation therapy could improve survival in some patients with unresectable gallbladder cancer.
Uno
T
T
Department of Radiation Therapy, International Medical Center of Japan, Tokyo, Japan.
Itami
J
J
Aruga
M
M
Araki
H
H
Tani
M
M
Kobori
O
O
D000230:Adenocarcinoma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005706:Gallbladder Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011879:Radiotherapy Dosage; D015996:Survival Rate; D013997:Time Factors