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Radiation therapy for extrahepatic bile duct cancer
Radiation therapy uses high-energy rays or particles to destroy cancer cells. Radiation may be used for extrahepatic bile duct cancer:
- to relieve pain or to control the symptoms of advanced extrahepatic bile duct cancer (palliative radiation therapy)
- as the main treatment, with or without chemotherapy, to destroy cancer cells if the tumour cannot be removed by surgery (is unresectable)
- after surgery to destroy cancer cells left behind and to reduce the risk of the cancer recurring (adjuvantadjuvantTreatment given in addition to the first-line therapy (the first or standard treatment) to help reduce the risk of a disease (such as cancer) coming back (recurring). radiation therapy)
- Few research studies support the effectiveness of radiation therapy in treating extrahepatic bile duct cancer after surgery. It's not clear if this treatment helps people live longer. Because extrahepatic bile duct cancer is so rare, few people have had treatment with radiation therapy in these situations, which it makes it difficult to fully evaluate.
The amount of radiation given during treatment, and when and how it is given, will be different for each person. Radiation treatments are usually given 5 days per week for several weeks.
External beam radiation therapy
Extrahepatic bile duct cancer may be treated with external beam radiation therapy. A machine directs radiation to the tumour and some of the surrounding tissue. Radiation therapy may be given along with chemotherapy drugs called radiosensitizers, which may make the radiation more effective. Giving radiation therapy and chemotherapy together is called chemoradiation.
Extrahepatic bile duct tumours that are small and unresectable or that have spread too far to be completely removed by surgery may be treated with external beam radiation therapy.
An extrahepatic bile duct tumour can block the bile duct and cause jaundicejaundiceA condition in which the skin and whites of the eyes become yellow and urine is dark yellow. or pain if the tumour presses on nerves. Palliative radiation therapy may be used to shrink a tumour and help relieve symptoms.
Radiation therapy may also be used after surgery if cancer cells are found in the surgical margins. The radiation is directed to the area from where the bile duct was removed.
Brachytherapy is internal radiation therapy. A radioactive material (radioactive isotope) is placed right into, or very close to, the tumour. Radioactive materials can also be placed in the area from where the tumour was removed. The radiation kills the cancer cells over time.
Brachytherapy is sometimes used to treat extrahepatic bile duct cancer. This allows radiation therapy to be given with less damage to nearby normal tissue and surrounding organs. Intraluminal radiation therapyIntraluminal radiation therapyA type of radiation therapy that uses implants (needles, catheters, wires or seeds) to deliver radiation directly into or near a tumour. involves implanting radioactive seeds or pellets into the bile duct. Doctors usually implant the seeds with a tube inserted into the bile duct through a small incision in the skin (percutaneous transhepatic biliary catheter).
Brachytherapy treatments are usually given for a short time. The seeds and catheter are removed after the desired dose of radiation is delivered.
Brachytherapy may be used alone or in combination with external beam radiation therapy.