Becker Gerhild, Momm Felix, Schwacha Henning, Hodapp Norbert, Usadel Henning, Geissler Michael, Barke Annette, Schmitt-Gräff Annette, Henne Karl, Blum Hubert-E
Department of Medicine II, Freiburg University Hospital, Hugstetter Strasse 55, D-79106 Freiburg, Germany.
World J Gastroenterol. 2005 Aug 21;11(31):4923-6. doi: 10.3748/wjg.v11.i31.4923.
In view of the poor prognosis of patients with cholangiocarcinoma (CCC), there is a need for new therapeutic strategies. Inter-disciplinary therapy seems to be most promising. Radiotherapy is an effective alternative to surgery for hilar CCC (Klatskin tumors) if an adequate radiation dose can be delivered to the liver hilus. Here, we describe a patient for whom we used a stereotactic radiotherapy technique in the context of an inter-disciplinary treatment concept. We report a 45-year-old patient with a locally advanced Klatskin tumor. Explorative laparotomy showed that the tumor was not resectable. A metallic stent was implanted and the patient was treated by stereotactic radiotherapy using a body frame. A total dose of 48 Gy (3X4 Gy/wk) was administered. Therapy was well tolerated. After 32 mo, local tumor recurrence and a chest wall metastasis developed and were controlled by radio-chemotherapy. After more than 56 mo with a good quality of life, the patient died of advanced neoplastic disease. Stereotactic radiotherapy led to a long-term survival of this patient with a locally advanced Klatskin tumor. In the context of inter-disciplinary treatment concepts, this radiotherapy technique is a promising choice of treatment for patients with hilar CCC.
鉴于胆管癌（CCC）患者预后较差，需要新的治疗策略。多学科治疗似乎最具前景。对于肝门部CCC（Klatskin瘤），如果能将足够的放射剂量送达肝门，放射治疗是手术的有效替代方法。在此，我们描述一位在多学科治疗方案中采用立体定向放射治疗技术的患者。我们报告一名45岁局部晚期Klatskin瘤患者。 exploratory剖腹手术显示肿瘤无法切除。植入金属支架，患者使用体架进行立体定向放射治疗。给予总剂量48 Gy（3×4 Gy/周）。治疗耐受性良好。32个月后，出现局部肿瘤复发和胸壁转移，通过放化疗得到控制。在生活质量良好的情况下超过56个月后，患者死于晚期肿瘤疾病。立体定向放射治疗使该局部晚期Klatskin瘤患者长期存活。在多学科治疗方案中，这种放射治疗技术是肝门部CCC患者有前景的治疗选择。
