Cholangiocarcinoma producing parathyroid hormone-related peptide treated with chemoradiation using gemcitabine and S-1.

Although chemotherapy for cholangiocellular carcinoma (CCC) is administered to those patients who are inoperable, the results are largely disappointing, especially for CCC producing parathyroid hormone-related peptide (PTHrP). We encountered a 43-year-old man with hypercalcemia due to PTHrP secretion of CCC. As the tumor was inoperable, we treated him with gemcitabine (GEM), S-1 and radiation. The tumor size was reduced 55% and the serum PTHrP level decreased markedly after the chemoradiotherapy. Although the patient died after 14 months, this case clearly suggests that the combined chemoradiotherapy of GEM, S-1 and radiation, may be useful for the treatment of CCC producing PTHrP.