The use of percutaneous biliary drainage (PBD) in combination with radioactive 125I seed strand brachytherapy (ISSB) is a safe and effective treatment for hilar cholangiocarcinoma (CCA), according to a study published in BMC Cancer.

Patients with hilar CCA who received PBD in combination with ISSB had better 2-month local tumor control rates than patients who only received PBD (94.1% vs 26.7%; P <.05). These patients also had longer median progression-free survival (PFS; 4.3 months vs 2.8 months) and overall survival (OS) than patients who did not receive ISSB (13.5 months vs 8.8 months).

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The maximum tumor diameter decreased from 16.6 ± 6.7 mm to 6.6 ± 5.2 mm in the group that received both PBD and ISSB while it increased from 17.6 ± 5.5 mm to 23.2 ± 6.2 mm in the group that only received PBD.

No differences between the 2 groups were observed in regard to technical (100% vs 100%) or clinical successes (94.1% vs 93.3%). There were also no differences observed in the rates of early complications, such as biliary infection or fever with chills, or minor complications between the groups. Neither group experienced any severe complications.

“PBD combined with ISSB was safe and effective for treating [hilar CCA], inhibiting the local tumor and prolonging PFS and OS. Prospective randomized controlled studies are needed in the future to confirm these findings,” the authors wrote.

Data from a total of 64 patients with HCCA who were treated between April 2017 and April 2021 were retrospectively analyzed for the study. PBD in combination with ISSB was used in 34 of the patients while the other 30 patients received PBD only. Baseline characteristics were well-balanced and not significantly different between the 2 groups.

During the study, a total of 37 patients died (18 from the ISSB group and 19 from the control group). The reasons for death included pulmonary embolism (n=1), multiple organ failure (n=7), disease progression (n=28), and lung infection (n=1).


Zhang C, Song M, Sun Z, et al. Biliary drainage combined with simultaneous 125I seed strand brachytherapy for the treatment of hilar cholangiocarcinoma. BMC Cancer. Published online May 9, 2023. doi:10.1186/s12885-023-10868-5