Is external palliative radiotherapy for gallbladder carcinoma effective?
BACKGROUND
Gallbladder carcinoma is characterized by delayed diagnosis, ineffective treatment and poor prognosis. Surgical resection has been thought to be the treatment of choice, while the role of radiotherapy as adjuvant or palliative treatment has not been fully clarified in the literature.


METHODS
We present the case of a 45-year-old female, with unresectable gallbladder carcinoma, grade IV, histologically diagnosed during laparotomy. The patient was treated with palliative intent with percutaneous transhepatic biliary drainage. Furthermore, she received external radiotherapy by (60)Co, using a three-field technique (anterior-posterior and right lateral). The total dose was 3,000 cGy in 10 fractions, with 300 cGy per fraction, 5 days weekly.


RESULTS
The patient showed clinico-laboratory improvement and was discharged with a permanent percutaneous transhepatic endoprosthesis. During follow-up (10 and 12 months postirradiation), abdominal CTs showed no local extension of the tumor, while the patient had a good performance status. So far, 1 year after the diagnosis of gallbladder cancer she is still alive.


CONCLUSIONS
External radiotherapy seems to be a safe and effective method of palliative management of gallbladder carcinoma. However, further studies are necessary to determine the role of radiotherapy in palliative or adjuvant treatment of gallbladder carcinoma.
Eleftheriadis
N
N
First Propedeutic Department of Internal Medicine, AHEPA Hospital, Aristotles University of Thessaloniki, Greece. pipinely@yahoo.com
Pistevou-Gombaki
K
K
Plataniotis
G
G
Sofroniadis
I
I
Kouloulias
V
V
D003037:Cobalt Radioisotopes / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005706:Gallbladder Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care; D011867:Radioisotope Teletherapy; D011880:Radiotherapy Planning, Computer-Assisted; D014057:Tomography, X-Ray Computed
D003037:Cobalt Radioisotopes