Hepatobiliary Pancreatic Oncology Division, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa 277-8577, Japan.
J Hepatobiliary Pancreat Sci. 2012 Jul;19(4):301-5. doi: 10.1007/s00534-011-0499-x.
The prognosis of patients with biliary tract cancer remains unsatisfactory even with surgery owing to the high recurrence rate. Therefore, an effective adjuvant chemotherapy is required to prolong survival. A few randomized controlled trials in patients with limited biliary tract cancer have been reported, but the efficacy of adjuvant chemotherapy could not be clarified. To date, effective adjuvant chemotherapy with evidence has not been established, and the standard therapy for patients with resectable biliary tract cancer has only been surgical treatment. Recently, a number of newer toxic agents have been shown to induce response in patients with advanced biliary tract cancer. Moreover, the morbi-mortality rate of operation for this cancer has been decreasing owing to advances in operative techniques and perioperative management. Given this background, a number of adjuvant chemotherapy trials have been started using gemcitabine, capecitabine, S-1, and combination chemotherapy with platinum. The results of these trials will be reported in the near future. Overall, the important aspects of adjuvant chemotherapy for biliary tract cancer are to establish well-organized and active clinical trial study groups, to conduct well-designed multicenter randomized controlled trials, and to continue such trials without interruption in the future.
即使进行了手术，胆道癌患者的预后仍然不理想，因为复发率很高。因此，需要有效的辅助化疗来延长生存期。已经报道了一些针对局限性胆道癌患者的随机对照试验，但辅助化疗的疗效仍不清楚。迄今为止，尚未确立具有循证医学证据的有效辅助化疗方案，可切除胆道癌患者的标准治疗方法仅为手术治疗。最近，一些新型的毒性药物已被证明可诱导晚期胆道癌患者的反应。此外，由于手术技术和围手术期管理的进步，这种癌症的手术死亡率一直在下降。鉴于这种背景，已经开始使用吉西他滨、卡培他滨、替吉奥和铂类联合化疗进行了一些辅助化疗试验。这些试验的结果将在不久的将来公布。总的来说，胆道癌辅助化疗的重要方面是建立有组织、积极的临床试验研究小组，进行精心设计的多中心随机对照试验，并在未来继续进行此类试验，不中断。
