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SHR Neuro Cancer Cardio Lipid Metab Microb

Brunner, TB; Eccles, CL.
Radiotherapy and chemotherapy as therapeutic strategies in extrahepatic biliary duct carcinoma.
Strahlenther Onkol. 2010; 186(12):672-80 Doi: 10.1007/s00066-010-2161-y
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Leading authors Med Uni Graz
Brunner Thomas Baptist
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Abstract:
PURPOSE: this report aims to provide an overview on radiotherapy and chemotherapy in extrahepatic biliary duct carcinoma (BDC). PATIENTS AND METHODS: a PubMed research identified clinical trials in BDC through April 1, 2010 including randomised controlled trials, SEER analyses and retrospective trials. Additionally, publications on the technical progress of radiotherapy in or close to the liver were analysed. RESULTS: most patients with cholangiocarcinoma present with unresectable disease (80-90%), and more than half of the resected patients relapse within 1 year. Adjuvant and palliative treatment options need to be chosen carefully since 50% of the patients are older than 70 years at diagnosis. Adjuvant radiotherapy or chemotherapy after complete resection (R0) has not convincingly shown a prolongation of survival but radiotherapy did after R1 resection. However, data suggest that liver transplantation could offer long-term survival in selected patients when combined with neoadjuvant chemoradiotherapy in patients with marginally resectable disease. For patients with unresectable biliary tract carcinoma (BTC), palliative stenting was previously the treatment of choice. But recent SEER analyses show that radiotherapy prolongs survival, relieves symptoms and contributes to biliary decompression and should be regarded as the new standard. Novel technical advances in radiotherapy may allow for dose-escalation and could significantly improve outcome for patients with cholangiocarcinoma. CONCLUSION: both the literature and recent technical progress corroborate the role of radiotherapy in BDC offering chances for novel clinical trials. Progress is less pronounced in chemotherapy.
Find related publications in this database (using NLM MeSH Indexing)
Aged - administration & dosage
Bile Duct Neoplasms - drug therapy, mortality, radiotherapy, surgery
Bile Ducts, Extrahepatic - surgery
Chemotherapy, Adjuvant - administration & dosage
Cholangiocarcinoma - drug therapy, mortality, radiotherapy, surgery
Combined Modality Therapy - administration & dosage
Humans - administration & dosage
Liver Transplantation - administration & dosage
Neoadjuvant Therapy - administration & dosage
Palliative Care - administration & dosage
Radiotherapy Dosage - administration & dosage
Radiotherapy Planning, Computer-Assisted - administration & dosage
Radiotherapy, Adjuvant - administration & dosage
Radiotherapy, Intensity-Modulated - administration & dosage
Randomized Controlled Trials as Topic - administration & dosage
SEER Program - administration & dosage
Stents - administration & dosage
Survival Analysis - administration & dosage

Find related publications in this database (Keywords)
Bile duct cancer
Radiotherapy
Chemotherapy
Chemoradiotherapy
Review
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