Tollenaar R A, van de Velde C J, Taat C W, Gonzalez Gonzalez D, Leer J W, Hermans J
Department of Surgery, University Hospital Leiden, The Netherlands.
Eur J Surg. 1991 Oct;157(10):587-9.
The hospital records of patients with extrahepatic bile duct cancer who where treated surgically between 1968 and 1983 were reviewed. Of 55 patients, 16 (29%) received radiotherapy after surgery. The total dose given ranged from 40 to 60 Gy. Median follow-up time for analysis was 4.0 months and lasted until January 1988. The overall median survival was 4 months (range 0-36), that of the irradiated patients was 16 months (range 2-36), and that of the 39 patients who were not irradiated was 3 months (range 0-32). When the 13 post operative deaths were excluded the median survival was 4 months. Radiotherapy did not cause any severe complications. No firm conclusion about the role of radiotherapy can be drawn from these data because the patients were not randomly chosen to receive radiotherapy and selection was therefore biased. We conclude that most patients with extrahepatic bile duct cancer still die of locoregional disease. Effective adjuvant treatments are needed and should be evaluated in prospective randomized trials.
回顾了1968年至1983年间接受手术治疗的肝外胆管癌患者的医院记录。55例患者中，16例（29%）术后接受了放疗。放疗总剂量为40至60 Gy。分析的中位随访时间为4.0个月，持续至1988年1月。总体中位生存期为4个月（范围0至36个月），接受放疗患者的中位生存期为16个月（范围2至36个月），未接受放疗的39例患者的中位生存期为3个月（范围0至32个月）。排除13例术后死亡病例后，中位生存期为4个月。放疗未引起任何严重并发症。由于患者并非随机选择接受放疗，存在选择偏倚，因此无法从这些数据中就放疗的作用得出确凿结论。我们得出结论，大多数肝外胆管癌患者仍死于局部区域疾病。需要有效的辅助治疗，并应在前瞻性随机试验中进行评估。
