Combined modality therapy of extrahepatic biliary system cancer Journal Article


Authors: Minsky, B. D.; Wesson, M. F.; Armstrong, J. G.; Kemeny, N.; Reichman, B.; Botet, J.; Nori, D.
Article Title: Combined modality therapy of extrahepatic biliary system cancer
Abstract: From January 1985 to December 1988, 10 patients with local/regional extrahepatic biliary system cancer (gallbladder: 2, Klatskin: 4, common bile duct: 4) underwent combined modality therapy. Laparotomy and biopsy or subtotal resection were performed in six patients and endoscopic retrograde cholangiopancreatography, percutaneous transhepatic cholangiogram, and biliary drainage in four patients. Patients initially received 5000 cGy to the tumor bed and primary nodal area. Eight received an additional 1500 cGy boost to the tumor bed. Chemotherapy (5-FU/ mitomycin-C) was delivered at the beginning of each radiation treatment course. Four patients received an additional 1-4 cycles of maintenance chemotherapy and six received a boost with brachytherapy. The mean survival was 32 months and the median survival was 16 months. Five patients are currently NED at 16, 17, 17, 48, and 52 months. The overall 3-year actuarial survival was 50%. The cumulative incidence of failure as a component of failure was local/regional: 50%, abdominal: 40%, and distant: 10%. Of the five patients who developed failure, all developed a component of local/regional failure. Our data show that this approach is feasible and offers similar results to those reported in the literature. However, further follow-up will be needed to determine if this combined modality approach offers improved local control and survival rates compared with surgery or biliary bypass/drainage alone. © 1990.
Keywords: adult; cancer chemotherapy; fluorouracil; combined modality therapy; methodology; radiotherapy dosage; radiotherapy; iodine 125; brachytherapy; mitomycin c; radiation therapy; radioisotope; biliary tract cancer; iridium 192; radioisotope therapy; biliary tract neoplasms; bile duct cancer; endoscopic retrograde cholangiopancreatography; middle age; human; male; female; priority journal; article; support, non-u.s. gov't
Journal Title: International Journal of Radiation Oncology, Biology, Physics
Volume: 18
Issue: 5
ISSN: 0360-3016
Publisher: Elsevier Inc.  
Date Published: 1990-05-01
Start Page: 1157
End Page: 1163
Language: English
DOI: 10.1016/0360-3016(90)90453-q
PUBMED: 2347722
PROVIDER: scopus
DOI/URL:
Notes: Source: Scopus
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MSK Authors
  1. Bruce Minsky
    306 Minsky
  2. Nancy Kemeny
    544 Kemeny
  3. José F. Botet
    60 Botet
  4. Dattatreyudu Nori
    38 Nori