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Radiation therapy uses high-energy rays or particles to destroy cancer cells. Radiation isn't often used to treat bile duct cancer, still, it might be used in these ways:
The 2 main types of radiation therapy are external beam radiation therapy (EBRT) and brachytherapy. EBRT is the most common form of radiation for bile duct cancer.
In this type of radiation therapy, a machine sends x-rays to a specific part of the patient's body to kill cancer cells.
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. The treatment is much like getting an x-ray, but the radiation is much stronger. The procedure itself is painless. Each treatment lasts only a few minutes, but the set-up time – getting you into place for treatment – usually takes longer. Most often, radiation treatments are given 5 days a week for many weeks. These are some of the ways EBRT might be given:
Three-dimensional conformal radiation therapy (3D-CRT) uses special computers to precisely map the location of the tumor(s). Radiation beams are then shaped and aimed at the tumor(s) from several directions, which makes it less likely to damage normal tissues. It may be used to treat localized intrahepatic bile duct cancers that can't be removed with surgery.
Intensity-modulated radiation therapy (IMRT) is an advanced form of 3D-CRT. It uses a computer-driven machine that moves around you as it delivers radiation. Along with shaping the beams and aiming them at the cancer from many angles, the intensity (strength) of the beams can be adjusted to limit the dose reaching the most sensitive normal tissues. This lets doctors deliver an even higher dose to the cancer.
Stereotactic body radiotherapy (SBRT) uses the techniques of 3D-CRT and IMRT, but gives a high dose of radiation over fewer sessions. A course of SBRT may take a week or 2, while a course of radiation using these other techniques often takes 3 to 6 weeks.
Chemoradiation is when chemotherapy (chemo) is given along with EBRT to help it work better. It may be tried in select patients with early stage perihilar bile duct cancer before a liver transplant is done. The main drawback of this approach is that the side effects tend to be worse than giving radiation alone.
Some common side effects of ERBT to treat bile duct cancer include:
Side effects from radiation often start a week or 2 into treatment, and usually get better over time once treatment is over.
This type of treatment uses small pellets of radioactive material that are put next to or right into the tumor. The radiation travels a very short distance, so it affects the cancer without causing much harm to nearby healthy body tissues. For bile duct cancer, brachytherapy is sometimes done with a thin radioactive wire that's put into the bile duct for a short time. This may be called intrabiliary brachytherapy. Brachytherapy can be used alone, or it may be used along with EBRT. At this time it's mostly used as a palliative treatment.
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Abou-Alfa GK, Jarnagin W, Lowery M, D’Angelica M, Brown K, Ludwig E, Covey A, Kemeny N, Goodman KA, Shia J, O’Reilly EM. Liver and bile duct cancer. In: Neiderhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 5th ed. Philadelphia, PA. Elsevier; 2014:1373-1395.
Labib PL, Davidson BR, Sharma RA, Pereira SP. Locoregional therapies in cholangiocarcinoma. Hepat Oncol. 2017;4(4):99-109.
Lischalk JW, Repka MC, Unger K. Radiation therapy for hepatobiliary malignancies. J Gastrointest Oncol. 2017;8(2):279-292.
National Cancer Institute. Bile Duct Cancer (Cholangiocarcinoma) Treatment (PDQ®)–Patient Version. March 22, 2018. Accessed at www.cancer.gov/types/liver/patient/bile-duct-treatment-pdq on June 22, 2018.
National Comprehensive Cancer Network, Clinical Practice Guidelines in Oncology (NCCN Guidelines®), Hepatobiliary Cancers, Version 2.2018 -- June 7, 2018. Accessed at www.nccn.org/professionals/physician_gls/pdf/hepatobiliary.pdf on June 22, 2018.
Patel T, Borad MJ. Carcinoma of the biliary tree. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2015:715-735.
Rizvi S, Khan SA, Hallemeier CL, Kelley RK, Gores GJ. Cholangiocarcinoma: Evolving concepts and therapeutic strategies. Nat Rev Clin Oncol. 2018;15(2):95-111.
Last Revised: July 3, 2018