Chemotherapy and Radiation Therapy Because of the success of combined CT and RT in other gastrointestinal cancers, and the unsuccessful attempts at CT and RT alone, multimodality treatment has been applied to cholangiocarcinoma. There is limited data on the use of EBRT in combination with 5-FU specifically for extrahepatic cholangiocarcinoma. In a retrospective review, Kim et al looked at ≥40 Gy EBRT with concomitant bolus 5-FU (500mg/m2) for the first 3-days of each of two weeks of radiation, followed by monthly maintenance chemo with 5-FU for one year.15 Eighty four patients were included, of which 72 had a gross total resection (47 negative margins, 25 microscopically positive margins) and the remaining 12 had palliative procedures prior to the chemoradiation. The 5-year survival was 31%. Although this trial was specifically looking at postoperative chemoradiotherapy, the subset of patients that did not undergo gross total resection would apply to our study population. The 5-year actuarial survival was 14% overall for this subgroup.