Three-dimensional conformal radiotherapy combined with PTCD and PTBS for the treatment of malignant obstructive jaundice: a clinical analysis of 48 cases

Objective: To evaluate the curative effect of three-dimensional conformal radiotherapy (3D-CRT)combined with percutaneous transhepatic cholangiography and drainage (PTCD) and percutaneous transhepatic insertion of biliary stent (PTBS) for the treatment of malignant obstructive jaundice. Methods: PTCD and PTBS were carried out in 48 patients with malignant obstructive jaundice, which was followed by 3D-CRT. The total dose was 40 - 60 Gy/4 - 6 w with 2.0 Gy/fractionation, and five fractionation were performed every week. The short-term effect and the survival rate were assessed. Results: Successful drainage was achieved in all the 48 cases. The preoperative serum bilirubin level was (221.85± 54.73) μmol/. At one, two and three weeks after the treatment, the serum bilirubin level became (129.68 ±23.58) μmol/L, (88.29±15.70) μmol/L and (48.58±11.61) μmol/L, respectively. After 3D-CRT treatment, complete remission (CR) of the tumor was seen in 3, partial remission (PR) of the tumor in 36 and stable disease in 9 cases. The general response rate was 81.3%, and the one-year and two-year survival rates were 77.1% and 37.5% respectively. The median survival time was 18.5 months. No treatment-related serious complications occurred. Conclusion: For patients with malignant obstructive jaundice, 3D-CRT combined with PTCD and PTBS is a safe and effective palliative treatment. It can markedly relieve patient's clinical symptoms, improve the living quality and prolong the survival time. (authors)