[Effectiveness of Radiation Therapy for Postoperative Recurrent Biliary Tract Cancer]

Bile duct cancer recurrence after surgery often manifests as multiple metastases, making local therapy rarely applicable. Most patients are treated with systemic chemotherapy. However, we occasionally encounter cases that present as solitary or oligorecurrent lesions on imaging. In our hospital, we perform(chemo)radiation therapy only in these specific situations. All 5 cases showed favorable outcomes, and we report these results.

The primary disease was BDC/PVC/ GBC=2/2/1, and R0 radical resection was performed in all cases. The median time to recurrence was 466(range:140- 2,515)days, with recurrence sites being LN/lung/liver/bone=4/1/1/1. Multidisciplinary treatment was administered, and radiation therapy was performed on 1 target among the 5 cases(4 for lymph nodes and 1 for the lung). The median tumor diameter was 20(range:13-30)mm, and the irradiation dose was 60(range:58-60)Gy. Chemotherapy(GEM)was administered in 3 cases. RT response showed CR/PR/SD/PD=3/2/0/0, with all cases achieving tumor reduction. Two cases maintained their reduction and are alive without recurrence(OS after RT:52.7 months/79.2 months), while 2 cases maintained their reduction, but died from other diseases(OS after RT:17.1 months/25.5 months). One case involved the lungs, where disease progression occurred at 43.1 months, and the patient died from the original disease at 51.6 months after RT.