Cholangiocarcinoma medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Suveenkrishna Pothuru, M.B,B.S. [2]
Overview
Chemotherapy is indicated for unresectable cholangiocarcinoma as palliative chemotherapy. Chemotherapy agents used to treat cholangiocarcinoma include 5-fluorouracil, gemcitabine, irinotecan, cisplatin, or doxorubicin.
Medical Therapy
The majority of cases of cholangiocarcinoma present as unresectable disease.[1] If the tumor cannot be surgically removed, patients are often treated with palliative chemotherapy with or without radiotherapy.
Chemotherapy
- 1.Chemotherapy
- Preferred regimen (1): 5-fluorouracil 600 mg/m2 with leucovorin 400 mg/m2 over 2 hours once every 2 weeks
- Alternative regimen (2): Gemcitabine 1,000 mg/m2 plus cisplatin
- Alternative regimen (3): Irinotecan 125 mg/m2 q14 days
- Alternative regimen (4): Oxaliplatin 400 mg/m2
- Alternative regimen (5): Doxorubicin 60-75 mg/m2 q21 days
- Alternative regimen (6): Capecitabine 650 mg/m2 q21 days for 2 weeks
- Alternative regimen (7): Erlotinib PO 100 mg/day
Regional therapies
- Regional therapies is recommended among patients with small cholangiocarcinomas, when the general health condition of the patient does not allow a more aggressive treatment:[2][3]
- Transarterial chemoembolization (TACE)
- Radioembolization
Photodynamic Therapy
- Photodynamic therapy
- Injected with a light-sensitizing agent and light is then applied endoscopically directly to the tumor [4][5]
References
- ↑ Vauthey J, Blumgart L (1994). "Recent advances in the management of cholangiocarcinomas". Semin. Liver Dis. 14 (2): 109–14. PMID 8047893.
- ↑ Halappa VG, Bonekamp S, Corona-Villalobos CP, Li Z, Mensa M, Reyes D, Eng J, Bhagat N, Pawlik TM, Geschwind JF, Kamel IR (2012). "Intrahepatic cholangiocarcinoma treated with local-regional therapy: quantitative volumetric apparent diffusion coefficient maps for assessment of tumor response". Radiology. 264 (1): 285–94. doi:10.1148/radiol.12112142. PMID 22627601.
- ↑ Patel T (2011). "Cholangiocarcinoma--controversies and challenges". Nat Rev Gastroenterol Hepatol. 8 (4): 189–200. doi:10.1038/nrgastro.2011.20. PMC 3888819. PMID 21460876.
- ↑ Ortner M, Caca K, Berr F, Liebetruth J, Mansmann U, Huster D, Voderholzer W, Schachschal G, Mössner J, Lochs H (2003). "Successful photodynamic therapy for nonresectable cholangiocarcinoma: a randomized prospective study". Gastroenterology. 125 (5): 1355–63. PMID 14598251.
- ↑ Zoepf T, Jakobs R, Arnold J, Apel D, Riemann J (2005). "Palliation of nonresectable bile duct cancer: improved survival after photodynamic therapy". Am J Gastroenterol. 100 (11): 2426–30. PMID 16279895.