The Evolving Role of Radiation Therapy in the Treatment of Biliary Tract Cancer

Eleni Gkika, Maria A Hawkins, Anca-Ligia Grosu, Thomas B Brunner, Eleni Gkika, Maria A Hawkins, Anca-Ligia Grosu, Thomas B Brunner

Abstract

Biliary tract cancers (BTC) are a disease entity comprising diverse epithelial tumors, which are categorized according to their anatomical location as intrahepatic (iCCA), perihilar (pCCA), distal (dCCA) cholangiocarcinomas, and gallbladder carcinomas (GBC), with distinct epidemiology, biology, and prognosis. Complete surgical resection is the mainstay in operable BTC as it is the only potentially curative treatment option. Nevertheless, even after curative (R0) resection, the 5-year survival rate ranges between 20 and 40% and the disease free survival rates (DFS) is approximately 48-65% after one year and 23-35% after three years without adjuvant treatment. Improvements in adjuvant chemotherapy have improved the DFS, but the role of adjuvant radiotherapy is unclear. On the other hand, more than 50% of the patients present with unresectable disease at the time of diagnosis, which limits the prognosis to a few months without treatment. Herein, we review the role of radiotherapy in the treatment of cholangiocarcinoma in the curative and palliative setting.

Keywords: biliary tract cancer; brachytherapy; chemoradiation; cholangiocarcinoma; stereotactic body radiotherapy.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2020 Gkika, Hawkins, Grosu and Brunner.

Figures

Figure 1
Figure 1
The classification of biliary tract cancers, overall survival and patterns of recurrence.
Figure 2
Figure 2
Flow chart illustrating the integration of radiotherapy in the treatment of biliary tract cancers.

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