Sakata Takeshi, Yoshikawa Takahiro, Nomi Takeo, Matsuo Yasuko, Kamitani Naoki, Hokuto Daisuke, Sho Masayuki
Department of Surgery, Nara Medical University, 840 Shijo-cho Kashihara-shi, Nara, 634-8522 Japan.
Int Cancer Conf J. 2020 Sep 19;10(1):41-45. doi: 10.1007/s13691-020-00445-z. eCollection 2021 Jan.
Patients with advanced unresectable hilar cholangiocarcinoma have poor prognosis, and the survival is usually short. Herein, we report a 9-year survival case of unresectable hilar cholangiocarcinoma treated with chemoradiotherapy. A 64-year-old male patient presented with hilar cholangiocarcinoma. The tumor was located in the right hepatic duct, and it extended from the bifurcation of the anterior and posterior branches to the periphery. In the left side, the tumor extended from the umbilical portion to B2 and B3. However, there was no distant metastasis. The patient was then diagnosed with locally advanced, unresectable hilar cholangiocarcinoma and was treated with chemoradiotherapy. He received a total dose of 60 Gy in 30 daily fractions via intensity-modulated radiation therapy. In addition, he received gemcitabine chemotherapy for 5 years. There has been neither re-elevation of carbohydrate antigen 19-9 levels nor tumor relapse for 5 years during chemotherapy. Therefore, gemcitabine treatment was discontinued. However, the patient experienced tumor relapse 3 years after the last chemotherapy. Hence, chemotherapy with gemcitabine and cisplatin was initiated. At present, 1 year has passed after treatment for recurrence, and the patient has survived for 9 years since the initial treatment. Herein, we report a rare case of long-term survival with chemoradiotherapy in locally advanced unresectable hilar cholangiocarcinoma.
晚期不可切除肝门部胆管癌患者预后较差，生存期通常较短。在此，我们报告一例经放化疗治疗的不可切除肝门部胆管癌患者存活9年的病例。一名64岁男性患者被诊断为肝门部胆管癌。肿瘤位于右肝管，从前、后分支的分叉处延伸至周边。在左侧，肿瘤从脐部延伸至B2和B3。然而，并无远处转移。该患者随后被诊断为局部晚期、不可切除的肝门部胆管癌，并接受了放化疗。他通过调强放射治疗，每日一次，共30次，总剂量达60 Gy。此外，他接受了5年的吉西他滨化疗。化疗期间5年，糖类抗原19-9水平既未再次升高，也无肿瘤复发。因此，停止了吉西他滨治疗。然而，患者在最后一次化疗后3年出现肿瘤复发。于是，开始使用吉西他滨和顺铂进行化疗。目前，复发治疗后已过去1年，患者自初始治疗以来已存活9年。在此，我们报告一例局部晚期不可切除肝门部胆管癌经放化疗长期存活的罕见病例。
