A COMPARATIVE STUDY OF TWO HYPOFRACTIONATED EXTERNAL BEAM RADIATION THERAPY SCHEDULES IN SYMPTOM PALLIATION IN UNRESECTABLE CARCINOMA GALLBLADDER

Introduction: Gallbladder cancer is a highly aggressive cancer, with majority of the patients presenting in advanced stage having a dismal prognosis.

Objective: The aim of the study, is to compare the symptom relief, loco-regional tumour response and tolerance between the two different external beam radiation therapy schedules.

Methods: A randomized study was conducted for two years including 60 patients. The patients were divided into two arms, with Arm-A receiving a total dose of 33Gy/15# and theArm-B receiving 30Gy/10#.

Results: Early tumour response was slightly better in Arm-B than in Arm-A, with 50% patients showing partial response in Arm-B in comparison to 40% in Arm-A. Symptom relief was better and statistically significant in Arm-B with respect to Arm-A. At 3 and 6 month follow up, the symptomatic relief was comparable between the two arms, with 72% patients having relief of nausea/ vomiting in Arm-B with respect to 39.1% patients in Arm-A. The weekly toxicities were almost comparable between the arms, with haematological toxicities being slightly higher in Arm-A as compared to Arm-B. Late treatment related toxicities were also higher in Arm-A as compared to Arm-B.

Conclusion: Palliative radiation therapy given to patients, over a short period of time is better in comparison to similarequivalent dose given over longer period of time in symptom palliationfor patients with unresectable gallbladder cancer.