title: Chemoradiation and brachytherapy in extrahepatic bile duct carcinoma.
abstract: BACKGROUND
  To explore the role of radiotherapy in the extrahepatic bile duct carcinoma, and to understand if and when radiotherapy could be effective for this group of patients.
  
  
  METHODS
  A systematic review of recently published literature was completed. Recent studies using radiotherapy with survival data, resection rates and quality of life data have been analyzed.
  
  
  RESULTS
  There are no randomized trials regarding the treatment of extrahepatic cholangiocarcinoma. The bulk of available studies suggest that in some cases radio-chemotherapy can be used as adjuvant therapy. Radiotherapy could also have a role in unresectable cholangiocarcinoma: external radiotherapy or intraluminal brachytherapy--alone or in combination--could improve the outcome in selected patients. Finally, radiotherapy, and in particular intraluminal brachytherapy, could be used as a palliative treatment to improve the quality of life and in controlling symptoms.
  
  
  CONCLUSIONS
  The role of radiotherapy in extrahepatic cholangiocarcinoma remains undefined due to the lack of randomized trials or otherwise properly controlled studies.
authors.affiliation: Department of Radiation Oncology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Gian Carlo
authors.initials: GC
authors.lastname: Mattiucci
authors.affiliation: Department of Radiation Oncology, Catholic University of the Sacred Heart, Rome, Italy. Electronic address: rosa_autorino@yahoo.it.
authors.forename: Rosa
authors.initials: R
authors.lastname: Autorino
authors.affiliation: Department of Radiation Oncology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Giuseppe Roberto
authors.initials: GR
authors.lastname: D'Agostino
authors.affiliation: Department of Radiation Oncology, Catholic University of the Sacred Heart, Campobasso, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Deodato
authors.affiliation: Department of Radiation Oncology, Catholic University of the Sacred Heart, Campobasso, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Macchia
authors.affiliation: Digestive Endoscopy Unit, Department of Surgery, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Perri
authors.affiliation: Digestive Endoscopy Unit, Department of Surgery, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Tringali
authors.affiliation: Department of Radiation Oncology, Catholic University of the Sacred Heart, Campobasso, Italy.
authors.forename: Alessio Giuseppe
authors.initials: AG
authors.lastname: Morganti
authors.affiliation: Digestive Endoscopy Unit, Department of Surgery, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Mutignani
authors.affiliation: Department of Radiation Oncology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Valentini
mesh_terms: D001650:Bile Duct Neoplasms / Q000628:therapy*; D017734:Bile Ducts, Extrahepatic; D001918:Brachytherapy; D059248:Chemoradiotherapy; D018281:Cholangiocarcinoma / Q000628:therapy*; D006801:Humans; D016896:Treatment Outcome
keywords: Brachytherapy; Intraoperative radiotherapy; Palliative therapy; Radio-chemotherapy; Resectable cholangiocarcinoma; Unresectable cholangiocarcinoma