The role of radiation therapy in cancer of the extra-hepatic biliary system: An analysis of thirteen patients and a review of the literature of the effectiveness of surgery, chemotherapy and radiotherapy

Carcinoma of the gallbladder

“…Local recurrence is a common cause of death in patients who relapse after cholecystectomy [33]. In Kopelson's review, local recurrence was present or was a cause of death in 86% of 110 patients who died within 5 years after simple cholecystectomy [33].…”

“…The limitations of surgery to encompass all resectable tumor adequately in the majority of patients becomes apparent from the pattern of failure following resection for carcinoma of the gallbladder [33,34]. Local recurrence is a common cause of death in patients who relapse after cholecystectomy [33].…”

Clinical Study of Preoperative Radiotherapy for the Extrahepatic Cholangiocarcinoma

“…Therefore, various treatments [2, 4, 5, 9-12, 29, 30] have recently been per formed in many institutes. Kopelson et al [13] reported on radiotherapy for cholangiocarcinoma and encouraging results were seen with carefully planned megavoltage radiotherapy. Several radiotherapy methods have been proposed.…”

“…One of these methods, preoperative radiothera py, was carried out as a new randomized control trial for extrahepatic cholangiocarcinoma. This preoperative ra diotherapy was also useful to shorten the period of reduc tion in hyperbilirubinemia [13], This was partly due to the tumor necrosis and the clearing of the tumor obstruction.…”

“…There are many reports of radiotherapy in extrahepatic cholangiocarcinoma [13][14][15][16][17][18][19][20][21][22][23][24], but it is very rarely per formed preoperatively. It is said that exposure to a large total dose of radiation leads to fibrotic changes in tissues and difficulties in operative procedures.…”