悪性胆道閉塞に対するbrachytherapyの経験

概要

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Nine patients with malignant biliary obstruction (8 bile duct carcinoma,1 gallbladder cancer with common hepatic duct invasion) were treated with intraluminal irradiation using a high dose remote afterloading 192Iridium brachytherapy machine (microSelectron-HDR) via a percutneous transhepatic or an endoscopic transpapillary route.<BR>Radiation dose of 10-12Gy at 1cm from the radiation sourse was dilivered within several minutes at each procedure. The mean total dose of radiation was 28.8Gy (range,20 to 36Gy).<BR>Radiation was effective from the findings of recanalized stricture on cholangiography or disappeared tumor cells on biopsy specimens. The radiation procedure was well tolerated and no procedure-related complications were observed.<BR>The advantage of endoscopic transpapillary intraluminal brachytherapy should be stressed that it can be perfomed less invasively. The present, preliminary experience suggested that intraluminal irradiation is effective for local control of malignant biliary stricture.
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