| Theme |
Hilar and Intrahepatic Cholangiocarcinoma |
| Title |
Chemotherapy for Hilar Cholangiocarcinoma |
| Author |
Junji Furuse |
Department of Internal Medicine, Medical Oncology, Kyorin University School of Medicine |
| Author |
Atsuko Takasu |
Department of Internal Medicine, Medical Oncology, Kyorin University School of Medicine |
| Author |
Hiroshi Kitamura |
Department of Internal Medicine, Medical Oncology, Kyorin University School of Medicine |
| Author |
Akiyoshi Kasuga |
Department of Internal Medicine, Medical Oncology, Kyorin University School of Medicine |
| Author |
Fumio Nagashima |
Department of Internal Medicine, Medical Oncology, Kyorin University School of Medicine |
| [ Summary ] |
Based on results of randomized clinical trials, a combination of gemcitabine and cisplatin has been recognized as a standard therapy for unresectable biliary tract cancer including hilar cholangiocarcinoma. The combination of gemcitabine plus S-1 is also expected to exhibit promising results in combating biliary tract cancer. Although second line chemotherapy is necessary to improve survival rates, no standard therapy has been established. Molecular targeted therapy is also expected to be applied for biliary tract cancer. Targeted agents are currently under investigation. Jaundice and cholangitis develop due to extensive stenosis of the bile duct. The intrahepatic bile duct is especially affected in patients with hilar cholangiocarcinoma. It is necessary to treat emergent cholangitis and/or obstruction of biliary stents. This is especially so during chemotherapy because of bone marrow suppression. Since recurrence develops frequently even after curative surgery in hilar cholangiocarcinoma patients, adjuvant chemotherapy is vital. Large randomized clinical trials comparing forms of chemotherapy in clinical settings are currently being carried out. |