Outcomes in unresectable and locally advanced resected cholangiocarcinoma

Patients with cholangiocarcinomas often present with unresectable disease, which is associated with a poor clinical outcome and survival. A number of palliative options are available to patients; the evaluated article presented experience from a single institution of treating cholangiocarcinoma, either unresectable or locally advanced, with conformal radiotherapy and concurrent chemotherapy. Patients who had received biliary radiation for cholangiocarcinoma were identified from the hospital database, and information on the patients sourced from notes and reports. In total, 20 patients with a diagnosis of biliary tract cancer were included and received radical conformal radiotherapy with concurrent cisplatin/5-fluorouracil and sequential gemcitabine. The median overall survival was 20.4 months and the relapse-free survival was 9.6 months. Treatment failure within the radiotherapy field was recorded in 45% of patients; adverse events were minimal. This study adds to the retrospective data available regarding the management of patients with biliary tract carcinomas, and we have found in our own cohort of 45 patients that gemcitabine/platinum was a more effective combination than monotherapy.