Researchers examining the use of radiation therapy (RT) in the adjuvant and definitive treatment of cholangiocarcinoma (CCA) discovered it can achieve local control of the disease despite prognosis being poor, according to a study published in Oncology Research and Treatment. 

Read more about CCA epidemiology

CCA is a malignant cancer of the bile duct epithelium that is exceedingly rare, with an annual incidence of 0.5 to 2 per 100,000 people in Western countries. The only known curative treatment is surgery, but prognosis remains poor, with the median overall survival being just 9 months without adjuvant therapy. Studies have shown that the use of RT in the adjuvant and definitive setting is promising in improving survival. 

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This study is a monocentric and retrospective analysis of patients treated at the University Hospital of Muenster in Germany between January 2005 and September 2018. This study recruited 39 patients. They had either intrahepatic (n=11), hilar (n=26) or both intrahepatic and hilar CCA (n=2).

A total of 53 lesions were found, all of which were treated with RT in the definitive or adjuvant setting. Patients had follow-ups every 3 months for the first 2 years, and every 6-12 months after that, with the mean duration of follow-up after the last day of RT being 13.6 months.

Read more about CCA complications

At the end of the study, 31 of the 39 patients (79.5%) were deceased. Of the 8 patients alive, 1 (2.6%) had distant metastasis and another (2.6%) had a local recurrence. Taking all the 53 lesions into account, only 10 (10.9%) were noted to have local recurrence. 

“After RT, the median overall survival was 10.4 months, median progression-free survival was 5.6 months, and median duration of local control (DOLC) was 8.9 months,” wrote the authors of this study. The median DOLC was twice as long after treatment of a primary tumor compared to the recurrent situation (10.4 vs 5.4 months, P =.032). Most patients classified the side effects of RT as being mild to moderate. 


Oertel M, Gattermann F, Schmidt H, Eich HT. Examining the use of radiation therapy for cholangiocarcinoma: benefits through modern techniques. Oncol Res Treat. Published online July 21, 2021. doi:10.1159/000517533