Open Access Research

Patterns of radiotherapy practice for biliary tract cancer in Japan: results of the Japanese radiation oncology study group (JROSG) survey

Fumiaki Isohashi1, Kazuhiko Ogawa1*, Hirobumi Oikawa2, Hiroshi Onishi3, Nobue Uchida45, Toshiya Maebayashi6, Naoto Kanesaka7, Tetsuro Tamamoto8, Hirofumi Asakura9, Takashi Kosugi10, Takashi Uno11, Yoshinori Ito12, Katsuyuki Karasawa13, Makoto Takayama14, Yoshihiko Manabe15, Hideya Yamazaki16, Mitsuhiro Takemoto17, Yasuo Yoshioka1, Kenji Nemoto18, Yasumasa Nishimura19 and on behalf of the Japanese Radiation Oncology study Group (JROSG)

Author Affiliations

1 Department of Radiation Oncology, Osaka University Graduate School of Medicine, 2-2 (D-10) Yamadaoka, Suita, Osaka, 565-0871, Japan

2 Department of Radiology, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan

3 Department of Radiology, University of Yamanashi, 1110, Shimogato Chuo, Yamanashi, 409-3898, Japan

4 Department of Radiation Oncology, Shimane University, 1060 Nishikawatsu-cho, Matsue-shi, Shimane, 690-8504, Japan

5 Present affiliation: Department of Radiation Oncology, Tottori Prefectural Central Hospital, 730 Etsu, Tottori-shi, Tottori, 680-0901, Japan

6 Department of Radiology, Nihon University School of Medicine, 30-1, Ohyaguchi-Kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan

7 Department of Radiology, Tokyo Medical University, 6-1-1, Shinjuku, Shinjuju-ku, Tokyo, 160-8402, Japan

8 Department of Radiation Oncology, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan

9 Division of Radiation Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi Town, Shizuoka, 411-8777, Japan

10 Department of Radiology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu city, Shizuoka, 431-3192, Japan

11 Department of Radiology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chiba, 260-8677, Japan

12 Department of Radiation Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

13 Department of Radiation Oncology, Tokyo Metropolitan Komagome Hospital, 18-22, Honkomagome 3chome, Bunkyo-ku, Tokyo, 113-8677, Japan

14 Department of Radiology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan

15 Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Kawasumi, Mizuho-cho, Mizuho-ku Nagoya, Aichi, 467-8601, Japan

16 Department of Radiology, Kyoto Prefectural University of Medicine, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan

17 Department of Radiology, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama-shi, Okayama, 700-8558, Japan

18 Department of Radiation Oncology, Yamagata University, 2-2-2 Iida-Nishi, Yamagata-shi, Yamagata, 990-9585, Japan

19 Department of Radiation Oncology, Kinki University Faculty of Medicine, 377-2, Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan

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Radiation Oncology 2013, 8:76  doi:10.1186/1748-717X-8-76

Published: 1 April 2013



The patterns of radiotherapy (RT) practice for biliary tract cancer (BTC) in Japan are not clearly established.


A questionnaire-based national survey of RT used for BTC treatment between 2000 and 2011 was conducted by the Japanese Radiation Oncology Study Group. Detailed information was collected for 555 patients from 31 radiation oncology institutions.


The median age of the patients was 69 years old (range, 33–90) and 81% had a good performance status (0–1). Regarding RT treatment, 78% of the patients were treated with external beam RT (EBRT) alone, 17% received intraluminal brachytherapy, and 5% were treated with intraoperative RT. There was no significant difference in the choice of treatment modality among the BTC subsites. Many patients with EBRT were treated with a total dose of 50 or 50.4 Gy (~40%) and only 13% received a total dose ≥60 Gy, even though most institutions (90%) were using CT-based treatment planning. The treatment field consisted of the primary tumor (bed) only in 75% of the patients. Chemotherapy was used for 260 patients (47%) and was most often administered during RT (64%, 167/260), followed by after RT (63%, 163/260). Gemcitabine was the most frequently used drug for chemotherapy.


This study established the general patterns of RT practice for BTC in Japan. Further surveys and comparisons with results from other countries are needed for development and optimization of RT for patients with BTC in Japan.

Biliary tract cancer; Radiotherapy; Chemotherapy; Adjuvant; Palliative