Role of Radiation Therapy for Intrahepatic Cholangiocarcinoma

Abstract

Intrahepatic cholangiocarcinoma is a rare diagnosis, yet the incidence continues to rise worldwide. As these tumors often clinically present at an advanced stage, the majority of patients have unresectable disease at the time of diagnosis. Historically, these patients carried a very poor prognosis, as few nonsurgical liver-directed therapies provided meaningful improvement in outcomes. The use of radiotherapy was previously limited by concerns over radiation-induced liver disease with historical techniques; however, the advancement of three-dimensional conformal planning, stereotaxy, and charged particles as well as the development of normal tissue complication probability models have expanded the indications of radiation for these liver tumors. These advancements have improved local control and survival in patients with inoperable tumors. This chapter will review the indications, techniques, and outcomes of radiotherapy for intrahepatic cholangiocarcinoma in both the adjuvant and inoperable setting.