Tajima Hidehiro, Ohta Tetsuo, Shinbashi Hiroyuki, Hirose Atsushi, Tsukada Tomoya, Okamoto Koichi, Nakanuma Shinichi, Sakai Seisho, Furukawa Hiroyuki, Makino Isamu, Nakamura Keishi, Hayashi Hironori, Oyama Katsunobu, Inokuchi Masafumi, Nakagawara Hisatoshi, Miyashita Tomoharu, Fujita Hideto, Takamura Hiroyuki, Ninomiya Itasu, Kitagawa Hirohisa, Fushida Sachio, Fujimura Takashi, Mouri Hisatsugu, Ohtsubo Koushiro
Department of Gastroenterologic Surgery, Division of Cancer Medicine, Graduate School of Medical Science;
Oncol Lett. 2012 Dec;4(6):1281-1284. doi: 10.3892/ol.2012.909. Epub 2012 Sep 12.
A 56-year-old female with metastatic gallbladder cancer involving the liver and stenosis of the hilar bile duct was treated with gemcitabine (1,000 mg/m(2)) plus S-1 (60 mg/m(2)). After 9 cycles of therapy, CT showed evidence of stable disease; however, the serum CEA level was increased. Therefore, the chemotherapy regimen was changed to weekly low-dose paclitaxel (60 mg/m(2)). After 12 cycles of therapy, paclitaxel was reduced to 30 mg/m(2) as the patient developed neutropenia. The patient completed 32 cycles of therapy, and the tumor was reduced in size and marked improvement in bile duct stenosis was noted without any impairment in quality of life. The patient succumbed to the disease 25 months after treatment was initiated. Thus, in this case paclitaxel was more effective than gemcitabine plus S-1. Palliative chemotherapy with paclitaxel after failure of gemcitabine and 5-FU was well-tolerated; therefore, it may be an effective treatment for biliary tract cancer (BTC). A phase I study of palliative chemotherapy with weekly low-dose paclitaxel following gemcitabine (plus cisplatin) and 5-FU is currently in progress in patients with unresectable or recurrent BTC.
一名56岁女性，患有转移性胆囊癌，累及肝脏且肝门部胆管狭窄，接受吉西他滨（1000 mg/m²）加S-1（60 mg/m²）治疗。9个周期的治疗后，CT显示疾病稳定；然而，血清癌胚抗原（CEA）水平升高。因此，化疗方案改为每周低剂量紫杉醇（60 mg/m²）。12个周期的治疗后，由于患者出现中性粒细胞减少，紫杉醇剂量减至30 mg/m²。该患者完成了32个周期的治疗，肿瘤体积缩小，胆管狭窄明显改善，生活质量未受任何损害。治疗开始25个月后，患者死于该疾病。因此，在该病例中，紫杉醇比吉西他滨加S-1更有效。吉西他滨和5-氟尿嘧啶（5-FU）治疗失败后，采用紫杉醇进行姑息化疗耐受性良好；因此，它可能是胆管癌（BTC）的一种有效治疗方法。一项关于在吉西他滨（加顺铂）和5-FU治疗后，对不可切除或复发性BTC患者采用每周低剂量紫杉醇进行姑息化疗的I期研究目前正在进行。
