[A case of inoperable advanced bile duct cancer treated effectively with combined chemotherapy of gemcitabine and S-1].

The patient was a 63-year-old male. He was admitted to our department due to obstructive jaundice and acute renal failure, and was diagnosed with a lower bile duct cancer. As a result of a stent placement into the bile duct and hemodialysis, jaundice and renal failure improved. As scattered metastases were recognized on the superior surface of both hepatic lobes in intraoperative findings, only a portoenterostomy was performed. After that, 1,000 mg/m(2) of gemcitabine(day 1)and 60 mg/m(2) day of S-1(days 1-7)were administered repeatedly every other week as a course. One year and four months after the start of chemotherapy, radiation therapy of 40 Gy was performed at the site considered to be the remaining primary tumor according to the PET-CT findings. While chemotherapy was continued without change thereafter, the time passed with no visualization of lesions by CT. Two years and five months after the start of chemotherapy, duodenal stenosis and a metastasis in the liver occurred, resulting thereafter in aggravated conditions and death. The entire course lasted two years and eight months. We considered that combined therapy of gemcitabine and S-1 would be a useful option in chemotherapy for biliary tract cancer.