Flickinger J C, Epstein A H, Iwatsuki S, Carr B I, Starzl T E
Department of Radiation Oncology, University of Pittsburgh School of Medicine, Pennsylvania.
Cancer. 1991 Jul 15;68(2):289-94. doi: 10.1002/1097-0142(19910715)68:2<289::aid-cncr2820680213>3.0.co;2-2.
From 1976 to 1988, 63 patients received radiation therapy for primary cancers of the extrahepatic biliary system (eight gallbladder and 55 extrahepatic biliary duct). Twelve patients underwent orthotopic liver transplantation. Chemotherapy was administered to 13 patients. Three patients underwent intraluminal brachytherapy alone (range, 28 to 55 Gy). Sixty patients received megavoltage external-beam radiation therapy (range, 5.4 to 61.6 Gy; median, 45 Gy), of whom nine received additional intraluminal brachytherapy (range, 14 to 45 Gy; median, 30 Gy). The median survival of all patients was 7 months. Sixty patients died, all within 39 months of radiation therapy. One patient is alive 11 months after irradiation without surgical resection, and two are alive 50 months after liver transplantation and irradiation. Symptomatic duodenal ulcers developed after radiation therapy in seven patients but were not significantly related to any clinical variable tested. Extrahepatic biliary duct cancers, the absence of metastases, increasing calendar year of treatment, and liver transplantation with postoperative radiation therapy were factors significantly associated with improved survival.
1976年至1988年期间，63例患者接受了肝外胆管系统原发性癌症（8例胆囊癌和55例肝外胆管癌）的放射治疗。12例患者接受了原位肝移植。13例患者接受了化疗。3例患者仅接受腔内近距离放疗（范围为28至55 Gy）。60例患者接受了兆伏级外照射放疗（范围为5.4至61.6 Gy；中位数为45 Gy），其中9例接受了额外的腔内近距离放疗（范围为14至45 Gy；中位数为30 Gy）。所有患者的中位生存期为7个月。60例患者死亡，均在放疗后39个月内。1例患者在未进行手术切除的情况下放疗后11个月存活，2例患者在肝移植和放疗后50个月存活。7例患者放疗后出现有症状的十二指肠溃疡，但与所检测的任何临床变量均无显著相关性。肝外胆管癌、无转移、治疗年份增加以及肝移植术后放疗是与生存期改善显著相关的因素。
