Radiotherapy and particle therapy for unresectable cholangiocarcinoma

Abstract

Radiotherapy (RT) using X-rays and particle therapy (PT) using proton and heavy-ion beams for intrahepatic cholangiocarcinoma (IHCC) and perihilar cholangiocarcinoma (PHCC) are important treatment options as preoperative, postoperative, and definitive therapy. Postoperative adjuvant RT for resectable and definitive PT for unresectable IHCC have shown to be effective. The efficacy of postoperative adjuvant RT using intensity-modulated RT and definitive PT for unresectable PHCC are suggested. For safe RT and PT, spacer implantation has been attempted, and bioabsorbable spacers are currently available. RT and PT should be administered cautiously to avoid bile duct rupture and arterial injury caused by metallic biliary stents. Because RT and PT have minimal invasiveness and a wide range of treatment options, from palliative to radical, these should be considered as treatment options for any patient and tumor condition.