Background: Cholangiocarcinoma of the biliary tract is a rare tumour w
hich has been treated with surgery, radiotherapy, chemotherapy. bypass
procedures and stenting, Surgery remains the only curative treatment
fur these tumours, but a large proportion are unresectable. Intralumin
al brachytherapy has been reported as an effective treatment for local
ized cholangiocarcinoma of the biliary tract. The purpose of our study
was to analyse the survival of patients with biliary tract carcinoma
treated with iridium-192 brachytherapy. Methods: A retrospective revie
w of patients treated at Peter MacCallum uas undertaken. From 1989 to
1994, 16 patients underwent brachytherapy via a transhepatic approach
for cholangiocarcinoma. There were 12 male and four female patients. T
he median age was 65 (range 40-83). All patients had cholangiocarcinom
a. Prior treatment included complete resection in three, partial resec
tion in one, bypass procedures in eight, endoscopic stents in five and
external biliary drainage in 15 of the 16 patients. One patient had r
eceived external beam irradiation. Results: The median survival was 23
months and 61% survived 1 year. The most common acute complication wa
s cholangitis seen in four patients and the most common late complicat
ions were duodenal ulcer seen in two patients and cholangitis seen in
two patients. Conclusions: We conclude that iridium-192 brachytherapy
is a safe effective treatment for biliary tract carcinoma but a compar
ison between surgery and stenting would be of value. However, the cost
of brachytherapy is not cheap and its value in this regard should be
carefully analysed.