Extrahepatic biliary system cancer: An update of a combined modality approach Journal Article
| Authors: | Minsky, B. D.; Kemeny, N.; Armstrong, J. G.; Reichman, B.; Botet, J. |
| Article Title: | Extrahepatic biliary system cancer: An update of a combined modality approach |
| Abstract: | Since January 1985, 12 patients with local/regional extrahepatic biliary system cancer (2: gallbladder; 5: Klatskin; and 5: common bile duct) underwent combined modality therapy. An endoscopic retrograde cholangiopancreatography, percutaneous transhepatic cholangiogram, and biliary drainage were performed in 5 patients, and 7 patients underwent laparotomy and biopsy or subtotal resection. All patients initially received 5,000 cGy to the tumor bed and primary nodal area and 10 received an additional 1,500-cGy boost to the tumor bed. Chemotherapy (5-fluorouracil/mitomycin-C) was delivered at the beginning of each radiation treatment course. Four patients received an additional 1-4 cycles of maintenance chemotherapy and 7 received a boost with brachy-therapy. The median survival was 17 months and the overall 4-year actuarial survival was 36%. Four patients have no evidence of disease at 16, 30, 48, and 64 months, respectively. The patterns of failure as a component of failure were local/regional progression, 50%; abdominal failure, 58%; and distant failure, 8%. Of the 8 patients who developed failure, 6 developed a component of local/regional progression. Our data continue to show that this approach is feasible and may result in an improvement in survival. Continued follow-up will be needed to determine the ultimate impact of this aggressive approach. |
| Keywords: | adult; clinical article; aged; fluorouracil; blood toxicity; brachytherapy; mitomycin c; bile duct carcinoma; gallbladder cancer; human; article |
| Journal Title: | American Journal of Clinical Oncology |
| Volume: | 14 |
| Issue: | 5 |
| ISSN: | 0277-3732 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 1991-10-01 |
| Start Page: | 433 |
| End Page: | 437 |
| Language: | English |
| DOI: | 10.1097/00000421-199110000-00014 |
| PUBMED: | 1951179 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 27 September 2019 -- Source: Scopus |
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