title: Klatskin tumor treated by inter-disciplinary therapies including stereotactic radiotherapy: a case report.
abstract: In view of the poor prognosis of patients with cholangiocarcinoma (CCC), there is a need for new therapeutic strategies. Inter-disciplinary therapy seems to be most promising. Radiotherapy is an effective alternative to surgery for hilar CCC (Klatskin tumors) if an adequate radiation dose can be delivered to the liver hilus. Here, we describe a patient for whom we used a stereotactic radiotherapy technique in the context of an inter-disciplinary treatment concept. We report a 45-year-old patient with a locally advanced Klatskin tumor. Explorative laparotomy showed that the tumor was not resectable. A metallic stent was implanted and the patient was treated by stereotactic radiotherapy using a body frame. A total dose of 48 Gy (3X4 Gy/wk) was administered. Therapy was well tolerated. After 32 mo, local tumor recurrence and a chest wall metastasis developed and were controlled by radio-chemotherapy. After more than 56 mo with a good quality of life, the patient died of advanced neoplastic disease. Stereotactic radiotherapy led to a long-term survival of this patient with a locally advanced Klatskin tumor. In the context of inter-disciplinary treatment concepts, this radiotherapy technique is a promising choice of treatment for patients with hilar CCC.
authors.affiliation: Department of Medicine II, Freiburg University Hospital, Hugstetter Strasse 55, D-79106 Freiburg, Germany. becker@medizin.ukl.uni-freiburg.de
authors.forename: Gerhild
authors.initials: G
authors.lastname: Becker
authors.forename: Felix
authors.initials: F
authors.lastname: Momm
authors.forename: Henning
authors.initials: H
authors.lastname: Schwacha
authors.forename: Norbert
authors.initials: N
authors.lastname: Hodapp
authors.forename: Henning
authors.initials: H
authors.lastname: Usadel
authors.forename: Michael
authors.initials: M
authors.lastname: Geissler
authors.forename: Annette
authors.initials: A
authors.lastname: Barke
authors.forename: Annette
authors.initials: A
authors.lastname: Schmitt-Gräff
authors.forename: Karl
authors.initials: K
authors.lastname: Henne
authors.forename: Hubert-E
authors.initials: HE
authors.lastname: Blum
mesh_terms: D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D017809:Fatal Outcome; D006500:Hepatic Duct, Common; D006801:Humans; D018285:Klatskin Tumor / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed