Brachytherapy and percutaneous stenting in the treatment of cholangiocarcinoma: a prospective randomised study.
OBJECTIVE
To evaluate the effect of radiation therapy including intraluminal brachytherapy with iridium-192 on survival of patients with malignant biliary strictures (cholangiocarcinoma, histologically improved) treated with metallic stent in a prospective randomised study.


METHODS
In the prospective randomised study, 21 patients with cholangiocarcinoma were treated with implantation of percutaneous stents followed with intraluminal Ir-192 brachytherapy (mean dose 30 Gy) and external radiotherapy (mean dose 50 Gy) and 21 patients were treated only with stents insertion. We did not find any statistically significant differences in age and tumor localization between these two groups of patients.


RESULTS
All the patients died. In the group of patients treated with brachytherapy and with stent implantation, the mean survival time was 387.9 days. In the group of patients treated only with stent insertion the mean survival was 298 days. In effort to eliminate possible effect of external radiotherapy we treated the control group of eight patients with cholangiocarcinoma by stent insertion and brachytherapy only.


CONCLUSIONS
Our results show that combined radiation therapy could extend the survival in the patients with cholangiocarcinoma obstruction.
Válek
Vlastimil
V
Department of Radiology, FN Brno and LF MU Brno, Jihlavská 20, CZ-36900 Brno, Czech Republic. vlvalek@med.muni.cz
Kysela
Petr
P
Kala
Zdenek
Z
Kiss
Igor
I
Tomásek
Jirí
J
Petera
Jirí
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology* / Q000528:radiation effects / Q000601:surgery; D001662:Biliary Tract Surgical Procedures / Q000295:instrumentation; D001918:Brachytherapy / Q000379:methods; D018281:Cholangiocarcinoma / Q000532:radiotherapy* / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007496:Iridium Radioisotopes / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D015607:Stents; D016896:Treatment Outcome
D007496:Iridium Radioisotopes