Nakagawa Kei, Katayose Yu, Rikiyama Toshiki, Okaue Adoru, Unno Michiaki
Division of Hepato-Biliary Pancreatic Surgery, Tohoku University Graduate School of Medicine.
Gan To Kagaku Ryoho. 2009 Nov;36(12):2009-11.
Surgical resection is the gold standard of treatment for cholangiocarcinoma. However, there are also many recurrences after operation, because of the anatomical background and the tendency of invasion. We thought that eliminating the remnant of the cancer could yield a better prognosis. Therefore, an introduction of the neoadjuvant chemoradiation therapy with gemcitabine and surgical resection for advanced cholangiocarcinoma patient (NACRAC) was planned. The safety of NACRAC was confirmed by a pilot study. The recommended dose of gemcitabine (600 mg/m2) was determined by a phase I study. A phase II study is now being performed for evaluating the effectiveness and safety. NACRAC may control the frontal part of the tumor with difficult distinctions made by MDCT, and abolishing the cancer remnant is expected. The possibility of extended prognosis by NACRAC can be considered.
手术切除是胆管癌治疗的金标准。然而，由于解剖学背景和侵袭倾向，术后仍有许多复发情况。我们认为消除癌残留可能会带来更好的预后。因此，计划对晚期胆管癌患者引入吉西他滨新辅助放化疗及手术切除（NACRAC）。一项初步研究证实了NACRAC的安全性。吉西他滨的推荐剂量（600mg/m²）由一项I期研究确定。目前正在进行一项II期研究以评估其有效性和安全性。NACRAC可能会控制多层螺旋CT难以区分的肿瘤前部，并有望消除癌残留。可以考虑NACRAC延长预后的可能性。
