DEFINITIVE RADIATION-THERAPY FOR EXTRAHEPATIC BILE-DUCT CARCINOMA

PURPOSE: To evaluate retrospectively the role of radiation therapy for extrahepatic bile duct (EHBD) carcinoma. MATERIALS AND METHODS: Twent y-seven patients with local-regional EHBD carcinomas were treated with definitive radiation therapy. Radiation therapy was delivered by mean s of external beam radiation therapy (EBRT) alone or combined with tra nscatheter iridium-192 brachytherapy. The median total dose was 54 Gy (range, 30-144 Gy). Survival rates were calculated and compared by usi ng the log-rank test. Possible prognostic factors affecting survival w ere evaluated by means of univariate analysis. RESULTS: The median sur vival of all patients was 13 months, with 1- and 2-year actuarial surv ival rates of 52% and 10%, respectively. Univariate analysis revealed that men, patients with tumors limited to the bile duct, and patients receiving EBRT doses of at least 45 GY had significantly better outcom es. Local-regional recurrence was the main cause of treatment failure (82%). Two patients developed gastric outlet obstruction. CONCLUSION: Patients with locally advanced EHBD carcinomas have a low survival rat e. Certain factors, however, appear to have prognostic significance.