Oneda Ester, Abu Hilal Mohammed, Zaniboni Alberto
Department of Clinical Oncology, Fondazione Poliambulanza, 25124 Brescia, Italy.
Department of Surgery, Fondazione Poliambulanza, 25124 Brescia, Italy.
Cancers (Basel). 2020 May 14;12(5):1237. doi: 10.3390/cancers12051237.
Biliary tract cancers (BTCs) include cholangiocarcinomas and gallbladder cancers usually present at an advanced stage, which are considered resectable in less than 20% of cases and characterised by poor prognosis.
In this review, we discussed the most recent therapeutic options on the basis of the most updated and complete reviews and recent prospective studies in selected BTC patients.
Due to the high recurrence rate of BTCs, we suggest the new recommendations that have been made on adjuvant chemotherapy and radiotherapy treatment after surgery. New chemotherapy combinations in advanced-stage patients allow a better survival benefit than the standard treatment. Furthermore, the revelation of complex molecular events and their interactions and relationships with some risk factors allowed the development of targeted/toxic agents alone or combination with chemotherapy that is really promising. In unresectable patients, hepatic arterial infusion of high-dose chemotherapy or selective internal radiotherapy could offer a primary mass volume reduction or its resection with the maintenance of liver function.
The therapeutic landscape for BTCs is blooming again, the knowledge of their biology is still growing, but the available data on chemotherapy, radiotherapy, locoregional treatments, and target therapies have added hopes to improve patient survival.
胆道癌（BTCs）包括胆管癌和胆囊癌，通常在晚期出现，不到20%的病例被认为可切除，且预后较差。
在本综述中，我们根据最新、最完整的综述以及对选定BTC患者的近期前瞻性研究，讨论了最新的治疗选择。
由于BTCs的高复发率，我们提出了术后辅助化疗和放疗的新建议。晚期患者的新化疗方案比标准治疗具有更好的生存获益。此外，复杂分子事件及其相互作用以及与一些危险因素的关系的揭示，使得单独或与化疗联合使用的靶向/毒性药物的开发前景广阔。在不可切除的患者中，肝动脉灌注高剂量化疗或选择性内照射放疗可使原发肿块体积缩小或切除，同时维持肝功能。
BTCs的治疗前景再次蓬勃发展，对其生物学的认识仍在不断增长，但关于化疗、放疗、局部区域治疗和靶向治疗的现有数据为提高患者生存率增添了希望。
