Buskirk S J, Gunderson L L, Schild S E, Bender C E, Williams H J, McIlrath D C, Robinow J S, Tremaine W J, Martin J K
Section of Radiation Oncology, Mayo Clinic, Jacksonville, FL 32224.
Ann Surg. 1992 Feb;215(2):125-31. doi: 10.1097/00000658-199202000-00006.
Thirty-four patients with subtotally resected or unresectable carcinoma of the extrahepatic bile ducts received radiation therapy; a minimum of 45 Gy (external beam) to the tumor and regional lymph nodes +/- 5-fluorouracil (5-FU). Seventeen patients received an external beam boost of 5 to 15 Gy to the tumor, and a specialized boost was used in the remaining 17 patients (iridium-192 transcatheter seeds in 10 and intraoperative radiation therapy [IORT] with electrons in seven). The median time to death in all 34 patients was 12 months (range, 4 to 98-months). The only patients who survived longer than 18 months were those either with gross total or subtotal resection before external irradiation (2 of 6) or who received specialized boosts (192Ir, 3 of 10; IORT, 3 of 7). Local failure was documented in 9 of 17 patients who received external beam irradiation alone +/- 5-FU, 3 of 10 patients who received an 192Ir boost, and 2 of 6 patients who received an IORT boost with curative intent.
34例肝外胆管癌次全切除或无法切除的患者接受了放射治疗；肿瘤和区域淋巴结至少接受45 Gy（外照射），并加或不加5-氟尿嘧啶（5-FU）。17例患者接受了5至15 Gy的肿瘤外照射增敏，其余17例患者采用了特殊增敏方法（10例使用铱-192经导管植入籽源，7例使用术中电子线放射治疗[IORT]）。34例患者的中位死亡时间为12个月（范围4至98个月）。仅有的存活超过18个月的患者是那些在体外照射前接受了根治性全切除或次全切除的患者（6例中的2例），或接受了特殊增敏的患者（192Ir，10例中的3例；IORT，7例中的3例）。单独接受外照射加或不加5-FU的17例患者中有9例出现局部复发，接受192Ir增敏的10例患者中有3例出现局部复发，接受根治性IORT增敏的6例患者中有2例出现局部复发。
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