Gallbladder cancer: role of radiation therapy.
OBJECTIVE
Gallbladder carcinoma is characterized by late diagnosis, ineffective treatment and poor prognosis. These tumors were usually considered to be radioresistant. So far, the role of radiotherapy has not been adequately evaluated. The aim of this report is to assess the value of radiotherapy in carcinoma of the gallbladder.


METHODS
We reviewed all publications concerning the role of radiation therapy in gallbladder carcinoma. External radiation therapy, intra-operative radiation therapy, and brachytherapy were evaluated in two groups in which the prognosis is quite different; a group operated on, with apparent complete resection of the tumor, and a palliative surgery group.


RESULTS
It appears that gallbladder carcinomas are not as radioresistant as was formerly thought. Local control of the tumor and reduction of tumor size was reported in several publications. Collected data showed a slight improvement of survival after adjuvant or palliative radiotherapy, especially in the advanced stage of gallbladder carcinomas. It appears preferable to give a "boost" (15 Gy) to the gross lesion or residual lesion at operation (intra-operative irradiation or brachytherapy), and deliver an additional 45-50 Gy post-operatively.


CONCLUSIONS
The results published encourage further trials in well defined populations. Radiotherapy seems to be a safe procedure, morbidity is minimal, and a slight effect on survival is observed after curative or palliative surgical procedures.
Houry
S
S
Department of Surgery, Tenon Hospital, University Paris VI, France.
Haccart
V
V
Huguier
M
M
Schlienger
M
M
D001918:Brachytherapy; D002763:Cholecystectomy; D003131:Combined Modality Therapy; D005706:Gallbladder Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D010166:Palliative Care; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D015996:Survival Rate