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Endoscopic Intraductal Radiation Therapy for Unresectable Cholangiocarcinoma Using a Remote Afterloading Device
Author(s) -
KUBOTA Yoshitsugu,
KIN Hideyuki,
TAKAOKA Makoto,
INOUE Kyoichi,
MURATA Takashi,
TANAKA Yoshimasa
Publication year - 1996
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.1996.tb00426.x
Subject(s) - medicine , bile duct , radiology , catheter , radiation therapy , nuclear medicine , radiation dose , biopsy , cholangiography , surgery
The transpapillary technique of intracavitary irradiation has not gained wide acceptance due mainly to the development of the instruments used being in a relatively early stage. Intracavitary irradiation using a new high‐dose rate remote afterloading 192‐iridium brachytherapeutic device was performed utilizing an endoscopic transpapillary technique in four patients with cholangiocarcinomas obstructing the bile ducts. Via a prepositioned 10‐Fr nasobiliary catheter, a 12 Gy dose was administered at a distance of 1.0 cm from the radiation source at each procedure. Irradiation lasted several minutes (7.8 minutes on average). The procedure was repeated at 3‐day intervals, and the total dose ranged from 24 to 36 Gy. Cholangiography, performed immediately after completion of a series of irradiation treatments, disclosed various degrees of recanalization of the bile duct, and transpapillarily obtained biopsy specimens showed disappearance of tumor cells. All patients tolerated the radiation procedure well, and no procedure‐related complications were observed. The present preliminary experience suggests that transpapillary intracavitary irradiation has become technically feasible. Further experience in a larger series may demonstrate a role for this therapeutic modality in the treatment of unresectable cholangiocarcinoma.