Abstract
Purpose To assess the feasibility of intraluminal Pulsed Dose Rate (PDR) brachytherapy in the treatment of locally advanced bile duct cancer. Two cases are reported which were treated using a new trans-hepatic technique. Material and methods Two patients with advanced bile duct cancer were treated using trans-hepatic technique since May 2003 in Greatpoland Cancer Center. One patients was treated with combined treatment: brachytherapy and external beam therapy, one exclusively with brachytherapy. Percutaneous trans-hepatic technique was used to implant catheter into bile duct. Brachytherapy was started in the same day after insertion of intraductal catheter. A French 5 catheters (Nucietron) were used. Patients received 25 pulses of 0.8 Gy hourly, total dose was 20 Gy. Target Volume encompass tumour visualized at cholangiography and a 1 or 2 cm margin taken proximally and distally. Dose was prescribed at 10 mm from the source axis. In second phase of combined treatment – external beam therapy 15 MV photons were used. Patient received 40 Gy in 20 fractions of 2 Gy daily. Results and Conclusions It has been established, that the use of Pulsed Dose Rate brachytherapy is feasible and has a low early complication rate. A new percutaneous trans-hepatic technique allowed to perform whole treatment (insertion of catheter, PDR brachytherapy) in one day.
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