| Theme |
Malignant Biliary Stricture -- Recent Advancements on Diagnosis & Treatment |
| Title |
Radiotherapy for Biliary Tract Cancer |
| Author |
Tomomi Hikosaka |
Division of Gastrointestinal Oncology, Shizuoka Cancer Center |
| Author |
Akira Fukutomi |
Division of Gastrointestinal Oncology, Shizuoka Cancer Center |
| [ Summary ] |
For advanced biliary tract cancer (BTC), external-beam radiation therapy (EBRT) is generally used as radiotherapy. Intraluminal brachytherapy combined with EBRT is also used for making the treatment more effective. There are many reports suggesting that radiotherapy is useful to prolong survival or prolong stent patency. However, most of these reports are small prospective or retrospective studies and it is difficult to assess the true benefit of radiotherapy on the basis of current evidence. At present, systemic chemotherapy is a standard treatment for advanced BTC, and prospective randomised controlled trials (RCTs) are necessary to clarify the role of radiotherapy compared with systemic chemotherapy.
For resectable BTC, postoperative and/or intraoperative radiotherapy is occasionally performed to improve local control and survival. There are some reports demonstrating the potential benefits of adjuvant radiotherapy for resected BTC, especially for patients with positive microscopic margins or positive lymph nodes. But the significance of adjuvant treatment is not proven due to the lack of RCTs, and surgery alone remains the standard treatment for resectable BTC. Multi-institutional RCTs are needed to confirm the efficacy of adjuvant radiotherapy in BTC. |