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World J Gastrointest Endosc. Mar 16, 2022; 14(3): 106-112
Published online Mar 16, 2022. doi: 10.4253/wjge.v14.i3.106
Role of intraluminal brachytherapy in palliation of biliary obstruction in cholangiocarcinoma: A brief review
Divya Khosla, Samreen Zaheer, Rahul Gupta, Renu Madan, Shikha Goyal, Narendra Kumar, Rakesh Kapoor
Divya Khosla, Samreen Zaheer, Renu Madan, Shikha Goyal, Narendra Kumar, Rakesh Kapoor, Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, U.T., India
Rahul Gupta, Department of Gastroenterology and Hepatology, Shalby Multispeciality Hospital, Mohali 160062, Punjab, India
Author contributions: Khosla D contributed to conceptualization and manuscript preparation, writing, and editing and was responsible for the integrity of the article; Zaheer S and Gupta R contributed to literature search and manuscript writing and editing; Madan R contributed to literature search; Goyal S contributed to manuscript editing; Kumar N and Kapoor R reviewed and approved the manuscript.
Conflict-of-interest statement: The authors declare no conflicts of interest in the preparation of the manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Divya Khosla, MD, Associate Professor, Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research, Room No. 4, Radiotherapy Office, Ground Floor, Sector 12, Chandigarh 160012, U.T., India. dr_divya_khosla@yahoo.com
Received: May 30, 2021
Peer-review started: May 30, 2021
First decision: October 18, 2021
Revised: November 24, 2021
Accepted: February 25, 2022
Article in press: February 25, 2022
Published online: March 16, 2022
Abstract

Surgery is the only curative treatment for cholangiocarcinoma. However, most patients present with advanced disease, and hence are unresectable. Thus, the intent of treatment shifts from curative to palliative in the majority of cases. Biliary drainage with intraluminal brachytherapy is an effective means of relieving the malignant biliary obstruction. In this review, we discuss the role of brachytherapy in the palliation of obstructive symptoms in extrahepatic cholangiocarcinoma.

Keywords: Biliary tract, Cholangiocarcinoma, Extrahepatic, Intraluminal brachytherapy

Core Tip: Intraluminal brachytherapy (ILBT) is an effective means for palliation of biliary obstruction in patients with cholangiocarcinoma. It delivers a high dose of radiation to the tumor but spares surrounding normal tissues, thus avoiding many of the side effects seen with external beam radiation. The high dose per fraction in ILBT can have an ablative effect on the tumor and can lead to better symptom control and quality of life. ILBT, when combined with these drainage procedures, improves the stent patency rates by inhibiting tumor ingrowth.