Radiotherapy

• SBRT (Stereotactic Body Radiation Therapy)
• SIRT (Selective Internal Radiation Therapy)

Radiotherapy, which uses high energy x-rays to destroy cancer cells, is not routinely used to treat cholangiocarcinoma, although there may be occasions when it is used palliatively (to reduce symptoms).

SBRT (Stereotactic body radiotherapy)

SBRT gives radiotherapy from several different positions around the body, with the beams meeting at the tumour.  In this way, the tumour receives a high dose of radiation, but the tissues around it receive only a low dose, which lowers the risk of side effects.  SBRT is only suitable for those whose cancer has not spread to other parts of the body.   

SBRT may be given by a LINAC machine (a medical linear accelerator).  These machines are also known by the brand name of the manufacturer, such as CyberKnife and TrueBeam.

SIRT

Please note:  NHS England funding for SIRT, which had been available for patients with intrahepatic cholangiocarcinoma through the CtE (Commissioning through Evaluation) programme ceased on 31st March, 2017.

However, for those meeting the eligibility criteria, SIRT is still available privately, or by making an application for its use under exceptional circumstances.

SIRT (Selective Internal Radiation Therapy, also known as radio-embolisation) is a special type of internal radiotherapy that targets liver tumours inside the body with high doses of radiation.

SIRT involves injecting millions of tiny radioactive ‘beads’ called microspheres into the main blood vessel of the liver through a long thin tube (catheter). The microspheres travel through the blood to the liver and lodge themselves in the very small blood vessels in and around the liver tumours, where they give off high doses of radiation. As the microspheres only give off radiation to a small area, they target the liver tumour while doing little damage to the surrounding healthy liver tissue. The action of the radiation destroys the liver tumour cells causing the tumours to shrink.