Case Report
Copyright ©The Author(s) 2005. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 21, 2005; 11(31): 4923-4926
Published online Aug 21, 2005. doi: 10.3748/wjg.v11.i31.4923
Klatskin tumor treated by inter-disciplinary therapies including stereotactic radiotherapy: A case report
Gerhild Becker, Felix Momm, Henning Schwacha, Norbert Hodapp, Henning Usadel, Michael Geißler, Annette Barke, Annette Schmitt-Gräff, Karl Henne, Hubert E. Blum
Gerhild Becker, Henning Schwacha, Henning Usadel, Michael Geißler, Hubert E. Blum, Department of Medicine II, Freiburg University Hospital, Hugstetter Str. 55, Freiburg D-79106, Germany
Felix Momm, Norbert Hodapp, Annette Barke, Karl Henne, Department of Radiotherapy, Freiburg University Hospital, Robert-Koch-Str. 3, Freiburg D-79106, Germany
Annette Schmitt-Gräff, Institute of Pathology, Freiburg University Hospital, Albertstr. 19, Freiburg D-79106, Germany
Author contributions: All authors contributed equally to the work.
Correspondence to: Gerhild Becker, MD, Department of Medicine II, Freiburg University Hospital, Hugstetter Str. 55, Freiburg D-79106, Germany. becker@medizin.ukl.uni-freiburg.de
Telephone: +49-761-270-3213 Fax: +49-761-270-3213
Received: December 10, 2004
Revised: January 1, 2005
Accepted: January 5, 2005
Published online: August 21, 2005
Abstract

In view of the poor prognosis of patients with cholangiocarcinoma (CCC), there is a need for new therapeutic strategies. Inter-disciplinary therapy seems to be most promising. Radiotherapy is an effective alternative to surgery for hilar CCC (Klatskin tumors) if an adequate radiation dose can be delivered to the liver hilus. Here, we describe a patient for whom we used a stereotactic radiotherapy technique in the context of an inter-disciplinary treatment concept. We report a 45-year-old patient with a locally advanced Klatskin tumor. Explorative laparotomy showed that the tumor was not resectable. A metallic stent was implanted and the patient was treated by stereotactic radiotherapy using a body frame. A total dose of 48 Gy (3×4 Gy/wk) was administered. Therapy was well tolerated. After 32 mo, local tumor recurrence and a chest wall metastasis developed and were controlled by radio-chemotherapy. After more than 56 mo with a good quality of life, the patient died of advanced neoplastic disease. Stereotactic radiotherapy led to a long-term survival of this patient with a locally advanced Klatskin tumor. In the context of inter-disciplinary treatment concepts, this radiotherapy technique is a promising choice of treatment for patients with hilar CCC.

Keywords: Klatskin tumor; Stereotactic radiotherapy; Inter-disciplinary treatment