A prospective pilot study to evaluate the impact of palliative radiotherapy in upfront inoperable/chemo unfit patients with extrahepatic biliary tract tumors

Background: Extrahepatic biliary tract cancer (BTC) group of cancers are considered as highly lethal. Patients who are unfit for definitive treatment (surgery/chemotherapy) are usually kept on best supportive care (BSC) only. Literature regarding the role of palliative radiation therapy (RT) in this patient population is limited. Thus, this study aimed to evaluate the role of palliative RT in patients with advanced-stage BTC. Materials and methods: After obtaining institutional ethics committee approval, patients who fulfilled the inclusion or exclusion criteria were included in this study. Patients were treated by palliative RT (30 Gy/10#) by 3DCRT post-PTBD insertion, if jaundice was present. Patients were assessed for response, pain, and quality of life (QoL). Results were statistically analyzed using SPSS version 22. Results: Fifteen patients were selected for analysis. The mean age of the patients was 52 years (range 41–67 years). The female-to-male ratio was 4:1. Jaundice was the primary presenting symptom in 5/15 (33.33%) of patients, whereas pain alone and in combination with jaundice was observed in 3/15 (20%) and 7/15 (46.66%), respectively. Among all assessed, 53.33% showed a partial response, 26.66% showed stable disease, and 20% showed progressive disease, while no patients had a complete response. Grade 2 toxicities were observed mainly. Statistically significant changes were seen in visual analogue scores (VAS), and QoL showed improvement post RT. Conclusion: Palliative RT seems effective in patients with advanced-stage BTC who otherwise are kept on BSC only, with minimal and manageable toxicities. Studies with a larger sample size are warranted.