RADIOTHERAPY IN MALIGNANT OBSTRUCTIVE-JAU NDICE

Brachytherapy using the afterloading technique with iridium 192 and pe rcutaneous irradiation using 16 MV photons are used for the irradiatio n of malignant obstructive jaundice. Mostly, however, a combination of both methods can be used to advantage. In bile duct tumors and Klatsk in tumors, the endoluminal part can be treated using brachytherapy. Th e extralumenal growth and, if necessary, all affected regional lymph n ode areas can be treated by a 3D planned, percutaneous, moving field t echnique. Intraoperative radiotherapy can be used in a few cases as bo oster irradiation of tumor conglomerates at the porta hepatis. The dec ision to use irradiation must be made very carefully since solid tumor s are usually involved that require a high target dose, the applicatio n of which can lead to unacceptable side effects. The radio-oncologica l spectrum is therefore confined predominantly to palliative therapy.