Department of Medicine II, University Hospital Freiburg, Freiburg, Germany.
Curr Opin Gastroenterol. 2013 May;29(3):324-8. doi: 10.1097/MOG.0b013e32835d9dea.
Cholangiocarcinoma has a poor prognosis. Surgical resection offers the only curative option and usually requires a major hepatic resection in addition to resection of the cholangiocarcinoma. Unfortunately, curative resection is possible in only about 30% of patients due to locally advanced disease, distant metastases or comorbidity in elderly patients. Even after resection, the recurrence rate is approximately 60%, resulting in a low 5-year overall survival (OS). In unresectable cholangiocarcinoma OS with systemic chemotherapy is less than 1 year. Since most cholangiocarcinoma patients develop distant metastases at late stages only, locoregional therapy is an interesting therapeutic strategy. Here, we review the locoregional concepts of cholangiocarcinoma therapy.
Locoregional therapy studies in patients with intrahepatic cholangiocarcinoma employing radiofrequency ablation (RFA), transarterial chemoembolization (TACE) or external as well as internal radiation therapy yielded promising results in the last couple of years.
In conclusion, locoregional therapies have been shown to be effective in patients with intrahepatic cholangiocarcinoma. Local tumour control may prolong OS and can be achieved by locoregional interventions applied either sequentially or in combination with systemic chemotherapies.
胆管癌预后不良。手术切除是唯一的治愈方法，通常需要在切除胆管癌的基础上进行大范围肝切除术。但由于局部晚期疾病、远处转移或老年患者的合并症，只有约 30%的患者可以进行治愈性切除。即使进行了切除，复发率仍约为 60%，导致 5 年总生存率（OS）较低。对于不可切除的胆管癌，全身性化疗的 OS 不到 1 年。由于大多数胆管癌患者仅在晚期发生远处转移，因此局部区域治疗是一种有趣的治疗策略。在此，我们综述胆管癌局部区域治疗的相关概念。
近年来，射频消融（RFA）、经动脉化疗栓塞（TACE）或外部和内部放射治疗等局部区域疗法在治疗肝内胆管癌患者方面的研究取得了有前景的结果。
总之，局部区域治疗已被证明对肝内胆管癌患者有效。局部肿瘤控制可能延长 OS，并可通过序贯或联合全身化疗应用局部区域干预来实现。
