Fiorentini Giammaria, Mambrini Andrea, Sarti Donatella, Cantore Maurizio, Mulazzani Luca, Mattioli Gian Maria, Guadagni Stefano
Oncology Unit, Azienda Ospedaliera "Ospedali Riuniti Marche Nord", 61122 Pesaro, Italy.
Oncology Unit, Carrara General Hospital, Carrara, Italy.
Hepat Oncol. 2017 Apr;4(2):45-53. doi: 10.2217/hep-2017-0001. Epub 2017 Aug 31.
The aim is to report clinical outcomes of hepatic intra-arterial (IACHT) and systemic chemotherapy (SCHT), followed by gemcitabine-based maintenance therapy (maintenance), for the treatment of relapsed or unresectable cholangiocarcinoma.
PATIENTS & METHODS: In this retrospective observational study, 145 cholangiocarcinoma patients were treated with Epirubicin-Cisplatin as IACHT associated with Capecitabine or 5-fluorouracil as SCHT. Maintenance was performed with gemcitabine-based schedule. Toxicity was assessed with NCI-CTCAE and tumor response with RECIST 1.1.
Tumor response was complete in 1%, partial in 20%, stable disease in 48% and progression in 31% of patients (3 months after therapy). The most frequent adverse events were: anemia (24%), nausea and vomiting (33%), alopecia (60%).
Cholangiocarcinoma patients may benefit from IAHCT-SCHT. Maintenance may prolong clinical benefits. ClinicalTrials.gov registry Identifier: NCT01920503.
报告肝动脉内化疗（IACHT）和全身化疗（SCHT），随后进行吉西他滨维持治疗（维持治疗），用于治疗复发或不可切除胆管癌的临床结果。
在这项回顾性观察研究中，145例胆管癌患者接受表柔比星-顺铂作为肝动脉内化疗，联合卡培他滨或5-氟尿嘧啶作为全身化疗。采用基于吉西他滨的方案进行维持治疗。使用美国国立癌症研究所常见不良反应事件评价标准（NCI-CTCAE）评估毒性，使用实体瘤疗效评价标准（RECIST）1.1评估肿瘤反应。
治疗3个月后，1%的患者肿瘤反应为完全缓解，20%为部分缓解，48%为疾病稳定，31%为疾病进展。最常见的不良事件为：贫血（24%）、恶心和呕吐（33%）、脱发（60%）。
胆管癌患者可能从肝动脉内化疗联合全身化疗中获益。维持治疗可能延长临床获益。ClinicalTrials.gov注册号：NCT01920503。
