Ptcd Combined With3D-Crt Radiotherapy In The Treatment Of Hilar Cholangiocarcinoma

BackgroundIn the worldwide scale, the bile duct carcinoma accounts for about2%-3%of all gastrointestinal cancers and it is the second most common primary hepatobiliary malignant tumors. Hilar cholangiocarcinoma is one of the most common malignant tumors in the biliary system, accounting for40%-60%of all biliary tumors. Currently, radical surgical resection is the only curable way to hilar cholangiocarcinoma, but as its onset is occult, the majority of patients are diagnosed advanced or late, radical surgical resection becomes infeasible. As a result, select the appropriate palliative treatment has become the key to relieve the patients’clinical symptoms, improve quality of life and prolong survival.ObjectiveCompare the effect in the treatment of unresectable hilar cholangiocarcinoma through the PTCD combined with3D-CRT radiotherapy and PTCD independent therapy respectively.Data and MethodsWe collected a total of77cases that were confirmed as the unresectable hilar cholangiocarcinoma in the Qilu Hospital of Shandong University from January2006to April2012, including43males and34females, and the ratio of male to female was1.26:1.0, with an average age of approximately61.91years (39-82years). All the patients underwent the PTCD therapy, then the laparoscopy when their physical condition was improved, but9cases were ruled out of our study as they were found peritoneal metastasis. A total of36cases combined with the follow-up3D-CRT radiotherapy, While32cases were not. Then observe the patients who were followed up with or without complications. We used the SPSS18.0for Windows statistical software for all data processing, drawing survival curves. Then we went on the comparative analysis of different effects in the treatment of unresectable hilar cholangiocarcinoma by the PTCD combined with follow-up radiotherapy treatment and PTCD independent therapy respectively.ResultsIn the collected77cases, nine patients who were found with peritoneal metastases were excluded; the rest68cases met with the inclusion criteria. After extracting data, we used the SPSS18.0for Windows statistical software for processing. And the analysis results are as follows:①After the patients of the two groups undergoing the PTCD drainage, their bilirubin levels and jaundice decreased gradually:and symptoms of abdominal discomfort, poor appetite and others got eased to some extent;②The average survival time of the independent PTCD treatment group and the combined therapy group was10.9months,21.1months respectively; and the median survival was9months,14months respectively; and1,2-year survival rates were:34.4%.68.8%:4.4%.31.1%respectively.(P=0.02)ConclusionThrough our analysis, we conclude that for the patients with unresectable hilar cholangiocarcinoma, undergo the PTCD treatment will relieve the biliary obstruction which can ease the patient’s clinical symptoms, then on this basis, combined with3D-CRT radiotherapy can significantly further alleviate clinical symptoms, reduce complications, improve the life quality and prolong survival time.