Brachytherapy and percutaneous stenting in the treatment of cholangiocarcinoma: A prospective randomised study

Abstract 

Purpose

To evaluate the effect of radiation therapy including intraluminal brachyterapy with iridium-192 on survival of patients with malignant biliary strictures (cholangiocarcinoma, histologically improved) treated with metallic stent in a prospective randomised study.

Method and materials

In the prospective randomised study, 21 patients with cholangiocarcinoma were treated with implantation of percutaneous stents followed with intraluminal Ir-192 brachytherapy (mean dose 30Gy) and external radiotherapy (mean dose 50Gy) and 21 patients were treated only with stents insertion. We did not find any statistically significant differences in age and tumor localization between these two groups of patients.

Results

All the patients died. In the group of patients treated with brachytherapy and with stent implantation, the mean survival time was 387.9 days. In the group of patients treated only with stent insertion the mean survival was 298 days. In effort to eliminate possible effect of external radiotherapy we treated the control group of eight patients with cholangiocarcinoma by stent insertion and brachyterapy only.

Conclusion

Our results show that combined radiation therapy could extend the survival in the patients with cholangiocarcinoma obstruction.

Keywords: Stent, Brachytherapy, Radiotherapy, Cholangiocarcinoma, Biliary tree, Klatskin tumor