In patients with perihilar cholangiocarcinoma eligible for liver transplant, what is the protocol for neoadjuvant chemo-RT, particularly when brachytherapy is not available?

There is a lot of variability in neoadjuvant regimens prior to transplant for hilar cholangiocarcinoma as outlined in the survey paper above. Institutional approaches for total dose, fractionation, and target volumes vary considerably.

A couple of points to consider and some personal opinions - Phil...

Looking forward to hearing expert opinions on this, until then this is a nice paper from Drs. @Dr. First Last and @Dr. First Last at the University of Cincinnati reporting practice patterns of Neoadjuvant Therapy Regimens for Hilar Cholangiocarcinoma Before Liver Transplant. Table 2 lists the dose a...

Just as @Dr. First Last has suggested, there is considerable practice variation in this space and it’s nicely summarized in the study by Dr. @Dr. First Last et al., PMID 37036238.

For patients who are not brachy candidates or brachy is not successful for various technical reasons, following the initi...