Radiology Unit, Department of Digestive Diseases and Internal Medicine, General Hospital Sant’Orsola Malpighi, University of Bologna, Bologna, Italy.
Anticancer Res. 2013 Jun;33(6):2747-53.
To evaluate the survival of patients with unresectable perihilar cholangiocarcinoma (PHC) treated with multimodal palliative approaches.
thirty-two patients were enrolled in a multimodal protocol including: bilateral biliary drainage; Yridium-192 intraluminal brachytherapy (BT); metal biliary stenting; external-beam radiotherapy (EBRT); systemic chemotherapy (ChT). All patients underwent BT and biliary stenting: this was the only treatment for 14 patients, it was combined with EBRT in 11, and with EBRT and ChT in seven. Mean and median survival, complication rates and duration of hospital stay were calculated for each group.
BT with EBRT and ChT obtained the best median (15 months) and one year (71.42%) survival followed by BT with EBRT (14 months and 63.63%, respectively). BT with EBRT in a total dose of 54-60 Gy, with or without ChT, led to a significantly higher median survival rate (14 months) than that for BT alone (seven months).
BT with EBRT, with or without ChT, improves survival and should be considered as a suitable alternative to palliative surgery for patients with unresectable perihilar cholangiocarcinoma.
评估采用多种姑息治疗方法治疗不可切除的肝门周围胆管癌（PHC）患者的生存率。
32 名患者入组了一项多模式方案，包括：双侧胆道引流；钇-192 腔内近距离放疗（BT）；金属胆道支架；外照射放疗（EBRT）；全身化疗（ChT）。所有患者均接受 BT 和胆道支架治疗：14 名患者仅接受该治疗，11 名患者联合 EBRT，7 名患者联合 EBRT 和 ChT。计算每组的平均和中位生存期、并发症发生率和住院时间。
BT 联合 EBRT 和 ChT 获得了最佳的中位生存期（15 个月）和一年生存率（71.42%），其次是 BT 联合 EBRT（分别为 14 个月和 63.63%）。BT 联合 EBRT 总剂量为 54-60Gy，联合或不联合 ChT，中位生存期明显高于 BT 单独治疗（7 个月）。
BT 联合 EBRT，联合或不联合 ChT，可提高生存率，应被视为不可切除的肝门周围胆管癌患者姑息手术的一种合适替代方法。
