Pulmonary Medicine/Medical Oncology, KMC Hospital Ambedkar Circle, Mangalore, Karnataka, India
Oncology, Nottingham University Hospitals NHS Trust, Nottingham, UK.
BMJ Case Rep. 2023 Mar 2;16(3):e249681. doi: 10.1136/bcr-2022-249681.
Biliary tract cancer accounts for roughly 3% of adult malignancies of the gastrointestinal system. First-line treatment with gemcitabine-cisplatin chemotherapy is the standard for the management of metastatic biliary tract cancers. We present the case of a man who presented with abdominal pain, decreased appetite and weight loss for 6 months. Baseline evaluation revealed a liver hilar mass with ascites. Imaging, tumour markers, histopathology and immunohistochemistry revealed the diagnosis of metastatic extrahepatic cholangiocarcinoma. He was treated with gemcitabine-cisplatin chemotherapy followed by maintenance chemotherapy with gemcitabine and demonstrated an exceptionally good response and tolerance to chemotherapy with no long-term toxicity so far on maintenance therapy and progression-free survival exceeding 2.5 years after diagnosis. The rarity of this case is the exhibition of prolonged clinical response with maintenance chemotherapy for an aggressive cancer, thus needing further research into duration and outcomes of maintenance chemotherapy.
胆道癌约占成人胃肠道系统恶性肿瘤的 3%。吉西他滨-顺铂化疗作为转移性胆道癌的标准一线治疗。我们报告了一名男性病例，他因腹痛、食欲不振和体重减轻 6 个月就诊。基线评估显示肝门肿块伴腹水。影像学、肿瘤标志物、组织病理学和免疫组织化学显示为肝外胆管癌转移。他接受了吉西他滨-顺铂化疗，随后接受吉西他滨维持化疗，并表现出异常良好的化疗反应和耐受性，迄今为止维持治疗没有长期毒性，诊断后无进展生存期超过 2.5 年。这种情况的罕见之处在于维持化疗对侵袭性癌症表现出持久的临床反应，因此需要进一步研究维持化疗的持续时间和结果。
