肝外胆管癌放射治疗的研究进展

Research progress of radiotherapy for extrahepatic cholangiocarcinoma

肝外胆管癌手术切除后局部复发风险高,因此需进行辅助治疗提高无复发生存及总生存,其中放射治疗是重要的治疗手段。本文综述了辅助放射治疗、新辅助放射治疗、根治性放射治疗及姑息性放射治疗在胆外胆管癌治疗中的作用的研究进展。研究表明肝外胆管癌术后辅助放化疗可提高患者无瘤生存和总生存。对于不可切除肝门胆管癌,单独应用肝移植术的治疗结果令人失望,新辅助放化疗联合肝移植术已在不可切除肝门胆管癌中进行了探索,治疗结果令人鼓舞。对于不可切除肝外胆管癌,根治性放化疗延长了生存期。支架联合姑息性放射治疗可改善支架的通畅性并提高患者生活质量。放射治疗联合有效的多模式治疗为肝外胆管癌生存率的改善带来希望。

Extrahepatic cholangiocarcinoma has a high risk of local recurrence after surgical resection,so adjuvant therapy is needed to improve relapse-free survival and overall survival,among which radiotherapy is an important treatment.This article reviews the role of adjuvant radiotherapy,neoadjuvant radiotherapy,radical radiotherapy and palliative radiotherapy in the treatment of extrabiliary cholangiocarcinoma.Some studys showed that postoperative adjuvant chemoradiotherapy could improve the disease-free survival and overall survival of patients with extrahepatic cholangiocarcinoma.The results of liver transplantation alone have been disappointing for unresectable hilar cholangiocarcinoma,and neoadjuvant chemoradiotherapy combined with liver transplantation has been explored with encouraging results in unresectable hilar cholangiocarcinoma.For unresectable extrahepatic cholangiocarcinoma,radical chemoradiotherapy prolongs survival.Stenting combined with palliative radiotherapy can improve stent patency and improve the quality of life of patients.Radiotherapy combined with effective multimodal therapy holds promise for improving the survival rate of extrahepatic cholangiocarcinoma.