From 1992 to 1998, 41 patients received radiat´on therapy for primary cancers of the extrahepatic biliary system(seven gallbladder and 34 extrahepatic biliary duct). Chemotherapy was administered to 12 patients(29 percent). Fifteen patients(37 percent) also received postoperative radiotherapy. All patients received megavoltage external beam radiation therapy(range, 3000 to 5580 cGy; median, 5040 cGy). The median survival of all patients was 10 months. Median survivals according to treatment mode, radiation therapy only, chemotherapy with radiotherapy, and postoperative radiotherapy were 5, 15, and 13 months, respectively(p=0.0194). Another prognostic factors were .age(p=0.0248), weight loss(p=0.0446), and performance status(p=0.0296). Local failure was 53 %, distent metastasis was 26 % and both are 21 %.
Radiation therapy appeared to significantly extend survival in those inoperable patients. For more extent of survival, chemotherapy agent and new treatment modalities, as IORT(intraoperaive radiotherapy) and intraluminal brachytherapy will be introduce.
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