Chemoradiation and brachytherapy in biliary tract carcinoma: Long-term results

High dose chemoradiation for unresectable hilar cholangiocarcinomas using intensity modulated external beam radiotherapy: a single tertiary care centre experience

“…Crane et al observed that time to local progression was prolonged in the patients receiving RT doses between 54 to 85 Gy (12). This dose escalation can be achieved using EBRT alone or a combination of EBBT and EBRT (13)(14)(15)(16). Our study supports this view as we found no difference in MOS between patients in group I and group 2, indicating that it is high dose radiation which is effective regardless of the mode of delivery.…”

“…In some studies the incidence ranges from 9% to 40% (16,18,19). Since this depends on the proximity of the tumor to the duodenal and gastric mucosa, modern techniques using IMRT with IGRT can be potentially applied to reduce these late complications.…”

Intraductal therapies

“…Local radiotherapy can be administered in the form of brachytherapy [58,59], which involves intrabiliary placement of a radioactive source. Intrabiliary brachytherapy can be delivered either by the endoscopic method using a nasobiliary catheter or by the transhepatic route.…”

Protocol for a phase III randomized trial of chemoradiation and systemic chemotherapy vs. systemic chemotherapy alone in patients with unresectable nonmetastatic cholangiocarcinoma

“…The published results using chemoradiation for unresectable EHCC (other than Klatskin's tumors) report a median survival ranging from 10 months to 22 months, with some suggestion of improved outcomes when patients receive systemic chemotherapy and radiation doses >55 Gy. 7,9,[27][28][29][30][31] The results from studies using high dose radiation and systemic chemotherapy suggest that improved outcomes may be expected by combination of both approaches. The current standard of care for unresectable non-metastatic cholangiocarcinoma is systemic doublet chemotherapy.…”