Malignant tumor of
bile duct is a serious disease.
First, the cause of disease
Bile duct stones: Prolonged irritation of bile duct stones increases the risk of morbidity of bile duct malignancies.
-Primary sclerosing cholangitis: This is an autoimmune disease in which patients have a higher chance of developing malignant tumors of the bile duct.
-Bile duct cysts: The incidence of bile duct cancer is significantly higher in patients with congenital bile duct cysts.
2. Symptoms
-Jaundice: The most common symptom is yellowing of the skin and sclera, darkening of the urine and lightening of the stool.
-Abdominal pain: Pain in the right upper quadrant may occur, sometimes radiating to the back.
-Weight loss: Patients often experience gradual weight loss due to loss of appetite, indigestion, malabsorption, etc.
-Fever: Some patients may have fever, mostly low-grade fever.
3. Diagnosis
-Imaging tests, including ultrasound, CT, and magnetic resonance imaging (MRI), can help determine the location, size, and extent of the tumor.
-Laboratory tests, such as liver function tests and tumor marker tests, are helpful to assist diagnosis.
-Pathological examination: The gold standard for the diagnosis of bile duct malignant tumors is to obtain tissue specimens by percutaneous biopsy and endoscopic biopsy.
4. Treatment
-Surgical treatment: It is the main treatment for malignant tumors of bile duct, including radical surgery and palliative surgery. Radical surgery is suitable for early patients, the purpose is to remove the tumor and surrounding tissues; palliative surgery is mainly to relieve jaundice and improve the quality of life of patients.
-Chemotherapy: It can control the growth and spread of tumors to a certain extent. Commonly used chemotherapy drugs include gemcitabine, cisplatin, etc.
-Radiotherapy: Radiotherapy can be used as an adjuvant treatment for patients who cannot be resected surgically.
-Interventional therapy, such as percutaneous transhepatic biliary drainage (PTCD), endoscopic retrograde cholangiopancreatography (ERCP) and stent placement, can relieve jaundice and other symptoms.
The prognosis of
bile duct malignant tumors is poor. Early diagnosis and timely treatment are essential to improve the survival rate of patients.
Radiotherapy
for cholangiocarcinoma mainly includes the following aspects:
I. The role
of radiotherapy
1. Adjuvant therapy
-For resectable cholangiocarcinoma, radiotherapy can reduce the tumor volume before surgery and improve the success rate of surgical resection; radiotherapy after surgery can kill residual cancer cells and reduce the risk of recurrence.
2. Palliative care
For patients with unresectable cholangiocarcinoma, radiotherapy can relieve pain, jaundice and other symptoms caused by tumors, improve the quality of life of patients and prolong survival.
Second, the way
of radiotherapy
1. External beam radiotherapy
The tumor site is irradiated from outside the body
with high-energy radiation. This type of radiotherapy can accurately locate the tumor and reduce the damage to the surrounding normal tissue.
-Common external beam radiotherapy techniques include three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT), which can adjust the intensity and direction of radiation according to the shape and size of the tumor to improve the effect of radiotherapy.
2. Internal radiotherapy
-Also known as brachytherapy, it involves placing radioactive material directly inside or near a tumor for irradiation.
Internal radiation therapy can give a higher dose to the tumor while reducing the radiation to the surrounding normal tissue. The common internal radiotherapy methods are radioactive seed implantation and intracavitary radiotherapy.
Side effects
of
radiotherapy
1. Digestive system reaction
-Nausea, vomiting, loss of appetite, etc., due to irritation of the gastrointestinal tract by radiotherapy. It can be alleviated by dietary adjustment, medication and other methods.
2. Skin reaction
-Redness, itching, peeling and other symptoms may occur on the skin of the radiotherapy site. The skin should be kept clean to avoid friction and irritation, and medication can be used if necessary.
3. Hematological reactions
-Radiation therapy may cause a decrease in white blood cells, platelets and other blood cells, increasing the risk of infection and bleeding. Regular blood tests are needed and appropriate treatment is needed according to the situation.
4. Liver function damage
-Patients with cholangiocarcinoma may have abnormal liver function, and radiotherapy may aggravate liver function damage. Liver function should be closely monitored and hepatoprotective therapy should be given.