What is the efficacy of radiotherapy for the treatment of cholangiocarcinoma (CCC)?

Updated: Dec 28, 2019
  • Author: Peter E Darwin, MD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Answer

In patients with medially inoperable or unresectable tumors, primary radiotherapy, with or without chemotherapy, has provided a survival advantage and significant palliation over stent placement or bypass surgery alone. A study of 66 patients with unresectable intrahepatic cholangiocarcinoma treated with hypofractionated radiation therapy reported 2-year outcomes of 84% local control and 58% overall survival. [30]

In a study of 1636 patients with unresectable localized intrahepatic cholangiocarcinoma, the addition of radiation to chemotherapy was associated with an improvement in overall survival. Two-year overall survival was 20% for the chemotherapy-alone cohort versus 26% for the chemoradiation therapy group. [31]

Radioembolization with yttrium-90 has been shown to be safe and effective in patients with unresectable/recurrent intrahepatic cholangiocarcinoma. Mosconi et al reported significantly longer survival in patients who received radioembolization as initial therapy, compared with patients in whom radioembolization was preceded by other treatments, including surgery (52 vs 16 months, P=0.009). [32]


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