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Radiation Oncology • Gastrointestinal Cancers
How would you treat a recurrent chylothorax in a patient with metastatic cholangiocarcinoma?
Pleural fluid cytology is negative for malignancy but shows mesothelial cells. Would you use a PleurX or target with radiotherapy? From my understanding, malignant chylothorax is caused by compression of the thoracic duct, which can have an extrapulmonary etiology and target localization can be difficult.
Answer from: Radiation Oncologist at Academic Institution
I would not expect radiation to improve the situation. The only time that I have treated a tumor that I thought was causing a chylothorax it did not improve. Generally, radiation does not open obstructions of veins, ducts, or the GI tract.
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