Radiation therapy for gallbladder cancer

Radiation therapy uses high-energy rays (such as x-rays) or atomic particles to destroy cancer cells. There are different kinds of radiation therapy.

• External-beam radiation therapy (EBRT) uses x-rays or particles from a machine outside the patient's body to kill cancer cells.
• Brachytherapy (internal radiation therapy) uses small pellets of radioactive material placed next to or directly into the cancer.

External beam radiation therapy is the most common form of radiation therapy for gallbladder cancer. The treatment is much like getting an x-ray, but the radiation is more intense. The procedure itself is painless. Before your treatments start, the radiation team will take careful measurements to determine the correct angles for aiming the radiation beams and the proper dose of radiation. Each treatment lasts only a few minutes, but the setup time – getting you into place for treatment – usually takes longer. Most often, radiation treatments are given 5 days a week for several weeks.

Standard (conventional) EBRT is used much less often than in the past. With newer techniques, doctors can more accurately treat gallbladder cancers while reducing the radiation exposure to nearby healthy tissues. This may offer a better chance of increasing the success rate and reducing side effects.

Three-dimensional conformal radiation therapy (3D-CRT): 3D-CRT is a type of external beam radiation therapy that uses special computers to precisely map the location of the tumor(s). Radiation beams are shaped and aimed at the tumor(s) from several directions, which makes it less likely to damage normal tissues. Most doctors now recommend using 3D-CRT when it is available.

Uses of radiation therapy

Radiation therapy may be used in several ways to treat gallbladder cancer.

After surgery has removed the cancer: Radiation may be used to try to kill any cancer that might have been left after surgery but was too small to see. This is known as adjuvant therapy. Radiation therapy is often given along with a chemotherapy drugs such as 5-fluorouracil (5-FU) or capecitabine, which may make the radiation more effective. Giving chemotherapy and radiation together is called chemoradiation. Some studies have shown that giving chemoradiation after surgery may help patients live longer, especially those whose cancer had spread to lymph nodes.

As part of the main therapy for some advanced cancers: Radiation therapy can also be used as a main therapy for some patients whose cancer is not resectable but has not spread widely throughout the body. Most often it is given along with chemotherapy (chemoradiation). The treatment in this case does not cure the cancer, but it may help patients live longer. More research is needed to find out how useful such therapy is and to figure out the best way to give it.

As palliative therapy: Radiation therapy is often used to help relieve symptoms if the cancer is too advanced to be cured. It may be used to relieve pain or other symptoms by shrinking tumors that are blocking passageways for blood or bile, or are pressing on nerves. Doctors generally agree that palliative radiation therapy for gallbladder cancer is useful.

Possible side effects of radiation therapy

Side effects of external radiation therapy might include sunburn-like skin problems where the radiation enters the body, nausea, vomiting, diarrhea, and fatigue. Often these go away after treatment. When radiation is given with chemotherapy, the side effects are often worse.

For more general information about radiation therapy, please see our document, Understanding Radiation Therapy: A Guide for Patients and Families.