Squadroni Michela, Tondulli Luca, Gatta Gemma, Mosconi Stefania, Beretta Giordano, Labianca Roberto
Medical Oncology Unit, Humanitas Gavazzeni, Bergamo, Italy.
Medical Oncology Unit, Borgo Roma Hospital, Verona, Italy.
Crit Rev Oncol Hematol. 2017 Aug;116:11-31. doi: 10.1016/j.critrevonc.2016.11.012. Epub 2016 Nov 25.
Biliary tract cancer accounts for <1% of all cancers and affects chiefly an elderly population, with predominance in men. We distinguish cholangiocarcinoma (intrahepatic, hilar and distal) and gallbladder cancer, with different pathogenesis and prognosis. The treatment is based on surgery (whenever possible), radiotherapy in selected cases, and chemotherapy. The standard cytotoxic treatment for advanced/metastatic disease is represented by the combination of gemcitabine and cisplatin, whereas fluoropyrimidines are generally administered in second line setting. At the present time, no biologic drug demonstrated a clear efficacy in this cancer, although the molecular characterisation could provide a promising basis for experimental treatments. A good supportive care and an early palliative care are warranted in most patients and should be delivered as a part of a global approach.
胆道癌占所有癌症的比例不到1%，主要影响老年人群，男性居多。我们区分胆管癌（肝内、肝门和远端）和胆囊癌，它们具有不同的发病机制和预后。治疗方法包括手术（尽可能进行）、特定病例的放疗和化疗。晚期/转移性疾病的标准细胞毒性治疗方案是吉西他滨和顺铂联合使用，而氟嘧啶通常用于二线治疗。目前，尽管分子特征可为实验性治疗提供有前景的基础，但尚无生物药物在这种癌症中显示出明确疗效。大多数患者需要良好的支持性护理和早期姑息治疗，并且应作为整体治疗方法的一部分提供。
