Low-dose cisplatin plus 5-fluorouracil with radiotherapy for unresectable upper and hilar bile duct carcinoma

We report herein the value of a combined treatment modality for bile duct cancer (intraluminal brachytherapy: ILBT+extrabeam radiation therapy+chemotherapy+expandable metallic biliary stent), employed for cases in which excision of the upper and the hilar bile duct cancer was not possible. The combined treatment modality group did not attain a two-year survival rate according to the Kaplan Meier method. They were not able to surpass the treatment results of the excision group which ended in radical cure level of C. Moreover, with the combined modality treatment, the addition of radiation therapy significantly improved the cumulative survival rate. In conclusion, the first choice of treatment for the upper and the hilar bile duct cancer is excision, and it is necessary to thoroughly examine the possibility of excision. Additionally, to surpass the treatment results of the excision group that ended in a radical cure level of C, it is necessary to include radiation therapy and chemotherapy using new anti-cancer drugs in a combined treatment modality.