The role of intraoperative radiation therapy in the treatment of bile duct cancer View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

1988-02

AUTHORS

Yoji Iwasaki, Takeshi Todoroki, Katashi Fukao, Kiyoshi Ohara, Takao Okamura, Akira Nishimura

ABSTRACT

Since October, 1976, we have treated a total of 81 patients with bile duct cancer. Fifty of these patients had cancer that originated at and/or infiltrated into the main hepatic ducts. Five patients had cancer on the upper to middle portion, 19 on the middle to intrapancreatic bile duct, and the remaining 7 had diffusely involved tumors. Fifty of the 81 patients underwent resections. Of the 50 patients, 33 received curative or noncurative resection alone, 14 were treated by resection plus intraoperative radiotherapy (IORT), and the remaining 3 received postoperative external irradiation. Thirty-one of the 81 patients did not undergo tumor resection. Of these, 6 had IORT and 4 underwent external radiotherapy after bile drainage. The remaining 21 underwent bile drainage alone. Curative resection achieved the best cumulative 5-year survival rate of 59.3%. IORT plus noncurative resection showed a superior 2-year survival rate of 17,1% compared to 9.0% after noncurative resection alone. Only 1 patient treated by IORT plus bile drainage survived more than 2 years and subsequently died at 34 months.In the earlier stage of the development of the combination therapy with resection and IORT, severe complications were experienced in 9 patients (so treated), including remarkable obstructive changes of the hepatic arteries. In the later stage, resection plus IORT with a reduced single dose (20 Gy), using a smaller field size (3.7±1.4 cm) and beam energy (7.3±3.0 MeV), did not result in complication and produced 2 long-term survivors among 5 patients. Fractionated external irradiation (30–40 Gy/4–5 weeks) has been added to the IORT recently. These results indicate that noncurative resection plus IORT in combination with external radiation would improve the prognosis of the patient with advanced bile duct cancer. More... »

PAGES

91-98

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/bf01658492

DOI

http://dx.doi.org/10.1007/bf01658492

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1013815847

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/2830731


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194 Department of Surgery, Institute of Clinical Medicine, University of Tsukuba Medical School, Sakura-mura, Niihari-gun, 306, Ibaraki-Ken, Japan
195 Department of Surgery, Tsukuba Gakuen Hospital, Japan
196 rdf:type schema:Organization
 




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