Treatment of Unresectable Cholangiocarcinoma with Gemcitabine-Based Transcatheter Arterial Chemoembolization (TACE): A Single-Institution Experience
Background Survival for patients with unresectable cholangiocarcinoma is reported to range from only 5–8 months without treatment. Systemic chemotherapy has not been shown to significantly improve survival, but newer regimens involving gemcitabine have shown increased response rates. Transcatheter a...
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| Veröffentlicht in: | Journal of gastrointestinal surgery 2008, Vol.12 (1), p.129-137 |
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| creator | Gusani, Niraj J. Balaa, Fady K. Steel, Jennifer L. Geller, David A. Marsh, J. Wallis Zajko, Albert B. Carr, Brian I. Gamblin, T. Clark |
| description | Background
Survival for patients with unresectable cholangiocarcinoma is reported to range from only 5–8 months without treatment. Systemic chemotherapy has not been shown to significantly improve survival, but newer regimens involving gemcitabine have shown increased response rates. Transcatheter arterial chemoembolization (TACE) has been shown to prolong survival in hepatocellular carcinoma patients, but experience using TACE in the treatment of cholangiocarcinoma is limited. We report our experience treating cholangiocarcinoma with TACE using chemotherapeutic regimens based on the well-tolerated drug gemcitabine.
Methods
Forty-two patients with unresectable cholangiocarcinoma were treated with one or more cycles of gemcitabine-based TACE at our institution. Chemotherapy regimens used for TACE included: gemcitabine only (
n
= 18), gemcitabine followed by cisplatin (
n
= 2), gemcitabine followed by oxaliplatin (
n
= 4), gemcitabine and cisplatin in combination (
n
= 14), and gemcitabine and cisplatin followed by oxaliplatin (
n
= 4).
Results
Patients were 59 years of age (range 36–86) and received a median of 3.5 TACE treatments (range 1–16). Thirty-seven patients (88%) had central cholangiocarcinoma, and five (12%) had peripheral tumors. Nineteen patients (45%) had extrahepatic disease. Grade 3 adverse events (AEs) after TACE treatments were seen in five patients, whereas grade 4 AEs occurred in two patients. No patients died within 30 days of TACE. Median survival from time of first treatment was 9.1 months overall. Results did not vary by patient age, sex, size of largest initial tumor, or by the presence of extra-hepatic disease. Treatment with gemcitabine–cisplatin combination TACE resulted in significantly longer survival (13.8 months) compared to TACE with gemcitabine alone (6.3 months).
Conclusions
Our report represents the largest series to date regarding hepatic-artery-directed therapy for unresectable cholangiocarcinoma and provides evidence in favor of TACE as a promising treatment modality in unresectable cholangiocarcinoma. Our results suggest that gemcitabine-based TACE is well tolerated and confers better survival when given in combination therapy (with cisplatin or oxaliplatin) for patients with unresectable cholangiocarcinoma. |
| doi_str_mv | 10.1007/s11605-007-0312-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_1112236777</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2789661171</sourcerecordid><originalsourceid>FETCH-LOGICAL-c370t-ccd32b40997b081c9f03c4d403cb10d3dffede66d1098bfebaff112b58d00e33</originalsourceid><addsrcrecordid>eNp1kU1vEzEQhi1ERT_gB3BBlrjAweBZZ9cbbiFKS6VKPbBI3Fb-mE1c7drBdgThd_CD65BIcOllZqR53nekeQl5DfwDcC4_JoCG16yMjAuo2P4ZuYBWCjZrquZ5mfkcWFXX38_JZUoPnIPk0L4g5yDbGmQlLsifLqLKE_pMw0C_-YgJTVZ6RLrchFH5tQtGReN8mBT96fKG3uBkXEGcR_ZZJbS0i8ono_IGM0a6iKU6NRYDnAJOOozut8ouePquWyxX7z_RBf3q_HpEdutTdnn3d7n6tS069AZfkrNBjQlfnfoV6a5X3fILu7u_uV0u7pgRkmdmjBWVnvH5XGregpkPXJiZnZWqgVthhwEtNo0tf2j1gFoNA0Cl69ZyjkJckbdH220MP3aYcv8QdtGXiz0UrhKNlLJQcKRMDClFHPptdJOK-x54f4ihP8bQH8ZDDP2-aN6cnHd6QvtPcfp7AaojkMrKrzH-d_pJ10ek5JZ6</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1112236777</pqid></control><display><type>article</type><title>Treatment of Unresectable Cholangiocarcinoma with Gemcitabine-Based Transcatheter Arterial Chemoembolization (TACE): A Single-Institution Experience</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Gusani, Niraj J. ; Balaa, Fady K. ; Steel, Jennifer L. ; Geller, David A. ; Marsh, J. Wallis ; Zajko, Albert B. ; Carr, Brian I. ; Gamblin, T. Clark</creator><creatorcontrib>Gusani, Niraj J. ; Balaa, Fady K. ; Steel, Jennifer L. ; Geller, David A. ; Marsh, J. Wallis ; Zajko, Albert B. ; Carr, Brian I. ; Gamblin, T. Clark</creatorcontrib><description>Background
Survival for patients with unresectable cholangiocarcinoma is reported to range from only 5–8 months without treatment. Systemic chemotherapy has not been shown to significantly improve survival, but newer regimens involving gemcitabine have shown increased response rates. Transcatheter arterial chemoembolization (TACE) has been shown to prolong survival in hepatocellular carcinoma patients, but experience using TACE in the treatment of cholangiocarcinoma is limited. We report our experience treating cholangiocarcinoma with TACE using chemotherapeutic regimens based on the well-tolerated drug gemcitabine.
Methods
Forty-two patients with unresectable cholangiocarcinoma were treated with one or more cycles of gemcitabine-based TACE at our institution. Chemotherapy regimens used for TACE included: gemcitabine only (
n
= 18), gemcitabine followed by cisplatin (
n
= 2), gemcitabine followed by oxaliplatin (
n
= 4), gemcitabine and cisplatin in combination (
n
= 14), and gemcitabine and cisplatin followed by oxaliplatin (
n
= 4).
Results
Patients were 59 years of age (range 36–86) and received a median of 3.5 TACE treatments (range 1–16). Thirty-seven patients (88%) had central cholangiocarcinoma, and five (12%) had peripheral tumors. Nineteen patients (45%) had extrahepatic disease. Grade 3 adverse events (AEs) after TACE treatments were seen in five patients, whereas grade 4 AEs occurred in two patients. No patients died within 30 days of TACE. Median survival from time of first treatment was 9.1 months overall. Results did not vary by patient age, sex, size of largest initial tumor, or by the presence of extra-hepatic disease. Treatment with gemcitabine–cisplatin combination TACE resulted in significantly longer survival (13.8 months) compared to TACE with gemcitabine alone (6.3 months).
Conclusions
Our report represents the largest series to date regarding hepatic-artery-directed therapy for unresectable cholangiocarcinoma and provides evidence in favor of TACE as a promising treatment modality in unresectable cholangiocarcinoma. Our results suggest that gemcitabine-based TACE is well tolerated and confers better survival when given in combination therapy (with cisplatin or oxaliplatin) for patients with unresectable cholangiocarcinoma.</description><identifier>ISSN: 1091-255X</identifier><identifier>EISSN: 1873-4626</identifier><identifier>DOI: 10.1007/s11605-007-0312-y</identifier><identifier>PMID: 17851723</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject><![CDATA[Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents - administration & dosage ; Bile Duct Neoplasms - diagnosis ; Bile Duct Neoplasms - mortality ; Bile Duct Neoplasms - therapy ; Bile Ducts, Intrahepatic ; Biopsy ; Chemoembolization, Therapeutic - methods ; Chemotherapy ; Cholangiocarcinoma - diagnosis ; Cholangiocarcinoma - mortality ; Cholangiocarcinoma - therapy ; Cholangiopancreatography, Endoscopic Retrograde ; Cisplatin - administration & dosage ; Contraindications ; Deoxycytidine - administration & dosage ; Deoxycytidine - analogs & derivatives ; Drug therapy ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Gastroenterology ; Gemcitabine ; Hepatectomy ; Hepatic Artery ; Humans ; Injections, Intra-Arterial ; Magnetic Resonance Imaging ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasm Staging ; Organoplatinum Compounds - administration & dosage ; Oxaliplatin ; Retrospective Studies ; Ribonucleotide Reductases - antagonists & inhibitors ; Surgery ; Survival Rate ; Time Factors ; Tomography, X-Ray Computed ; Treatment Outcome]]></subject><ispartof>Journal of gastrointestinal surgery, 2008, Vol.12 (1), p.129-137</ispartof><rights>The Society for Surgery of the Alimentary Tract 2007</rights><rights>The Society for Surgery of the Alimentary Tract 2008</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c370t-ccd32b40997b081c9f03c4d403cb10d3dffede66d1098bfebaff112b58d00e33</citedby><cites>FETCH-LOGICAL-c370t-ccd32b40997b081c9f03c4d403cb10d3dffede66d1098bfebaff112b58d00e33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11605-007-0312-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11605-007-0312-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17851723$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gusani, Niraj J.</creatorcontrib><creatorcontrib>Balaa, Fady K.</creatorcontrib><creatorcontrib>Steel, Jennifer L.</creatorcontrib><creatorcontrib>Geller, David A.</creatorcontrib><creatorcontrib>Marsh, J. Wallis</creatorcontrib><creatorcontrib>Zajko, Albert B.</creatorcontrib><creatorcontrib>Carr, Brian I.</creatorcontrib><creatorcontrib>Gamblin, T. Clark</creatorcontrib><title>Treatment of Unresectable Cholangiocarcinoma with Gemcitabine-Based Transcatheter Arterial Chemoembolization (TACE): A Single-Institution Experience</title><title>Journal of gastrointestinal surgery</title><addtitle>J Gastrointest Surg</addtitle><addtitle>J Gastrointest Surg</addtitle><description>Background
Survival for patients with unresectable cholangiocarcinoma is reported to range from only 5–8 months without treatment. Systemic chemotherapy has not been shown to significantly improve survival, but newer regimens involving gemcitabine have shown increased response rates. Transcatheter arterial chemoembolization (TACE) has been shown to prolong survival in hepatocellular carcinoma patients, but experience using TACE in the treatment of cholangiocarcinoma is limited. We report our experience treating cholangiocarcinoma with TACE using chemotherapeutic regimens based on the well-tolerated drug gemcitabine.
Methods
Forty-two patients with unresectable cholangiocarcinoma were treated with one or more cycles of gemcitabine-based TACE at our institution. Chemotherapy regimens used for TACE included: gemcitabine only (
n
= 18), gemcitabine followed by cisplatin (
n
= 2), gemcitabine followed by oxaliplatin (
n
= 4), gemcitabine and cisplatin in combination (
n
= 14), and gemcitabine and cisplatin followed by oxaliplatin (
n
= 4).
Results
Patients were 59 years of age (range 36–86) and received a median of 3.5 TACE treatments (range 1–16). Thirty-seven patients (88%) had central cholangiocarcinoma, and five (12%) had peripheral tumors. Nineteen patients (45%) had extrahepatic disease. Grade 3 adverse events (AEs) after TACE treatments were seen in five patients, whereas grade 4 AEs occurred in two patients. No patients died within 30 days of TACE. Median survival from time of first treatment was 9.1 months overall. Results did not vary by patient age, sex, size of largest initial tumor, or by the presence of extra-hepatic disease. Treatment with gemcitabine–cisplatin combination TACE resulted in significantly longer survival (13.8 months) compared to TACE with gemcitabine alone (6.3 months).
Conclusions
Our report represents the largest series to date regarding hepatic-artery-directed therapy for unresectable cholangiocarcinoma and provides evidence in favor of TACE as a promising treatment modality in unresectable cholangiocarcinoma. Our results suggest that gemcitabine-based TACE is well tolerated and confers better survival when given in combination therapy (with cisplatin or oxaliplatin) for patients with unresectable cholangiocarcinoma.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antineoplastic Agents - administration & dosage</subject><subject>Bile Duct Neoplasms - diagnosis</subject><subject>Bile Duct Neoplasms - mortality</subject><subject>Bile Duct Neoplasms - therapy</subject><subject>Bile Ducts, Intrahepatic</subject><subject>Biopsy</subject><subject>Chemoembolization, Therapeutic - methods</subject><subject>Chemotherapy</subject><subject>Cholangiocarcinoma - diagnosis</subject><subject>Cholangiocarcinoma - mortality</subject><subject>Cholangiocarcinoma - therapy</subject><subject>Cholangiopancreatography, Endoscopic Retrograde</subject><subject>Cisplatin - administration & dosage</subject><subject>Contraindications</subject><subject>Deoxycytidine - administration & dosage</subject><subject>Deoxycytidine - analogs & derivatives</subject><subject>Drug therapy</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gastroenterology</subject><subject>Gemcitabine</subject><subject>Hepatectomy</subject><subject>Hepatic Artery</subject><subject>Humans</subject><subject>Injections, Intra-Arterial</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Organoplatinum Compounds - administration & dosage</subject><subject>Oxaliplatin</subject><subject>Retrospective Studies</subject><subject>Ribonucleotide Reductases - antagonists & inhibitors</subject><subject>Surgery</subject><subject>Survival Rate</subject><subject>Time Factors</subject><subject>Tomography, X-Ray Computed</subject><subject>Treatment Outcome</subject><issn>1091-255X</issn><issn>1873-4626</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kU1vEzEQhi1ERT_gB3BBlrjAweBZZ9cbbiFKS6VKPbBI3Fb-mE1c7drBdgThd_CD65BIcOllZqR53nekeQl5DfwDcC4_JoCG16yMjAuo2P4ZuYBWCjZrquZ5mfkcWFXX38_JZUoPnIPk0L4g5yDbGmQlLsifLqLKE_pMw0C_-YgJTVZ6RLrchFH5tQtGReN8mBT96fKG3uBkXEGcR_ZZJbS0i8ono_IGM0a6iKU6NRYDnAJOOozut8ouePquWyxX7z_RBf3q_HpEdutTdnn3d7n6tS069AZfkrNBjQlfnfoV6a5X3fILu7u_uV0u7pgRkmdmjBWVnvH5XGregpkPXJiZnZWqgVthhwEtNo0tf2j1gFoNA0Cl69ZyjkJckbdH220MP3aYcv8QdtGXiz0UrhKNlLJQcKRMDClFHPptdJOK-x54f4ihP8bQH8ZDDP2-aN6cnHd6QvtPcfp7AaojkMrKrzH-d_pJ10ek5JZ6</recordid><startdate>2008</startdate><enddate>2008</enddate><creator>Gusani, Niraj J.</creator><creator>Balaa, Fady K.</creator><creator>Steel, Jennifer L.</creator><creator>Geller, David A.</creator><creator>Marsh, J. Wallis</creator><creator>Zajko, Albert B.</creator><creator>Carr, Brian I.</creator><creator>Gamblin, T. Clark</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>2008</creationdate><title>Treatment of Unresectable Cholangiocarcinoma with Gemcitabine-Based Transcatheter Arterial Chemoembolization (TACE): A Single-Institution Experience</title><author>Gusani, Niraj J. ; Balaa, Fady K. ; Steel, Jennifer L. ; Geller, David A. ; Marsh, J. Wallis ; Zajko, Albert B. ; Carr, Brian I. ; Gamblin, T. Clark</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c370t-ccd32b40997b081c9f03c4d403cb10d3dffede66d1098bfebaff112b58d00e33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antineoplastic Agents - administration & dosage</topic><topic>Bile Duct Neoplasms - diagnosis</topic><topic>Bile Duct Neoplasms - mortality</topic><topic>Bile Duct Neoplasms - therapy</topic><topic>Bile Ducts, Intrahepatic</topic><topic>Biopsy</topic><topic>Chemoembolization, Therapeutic - methods</topic><topic>Chemotherapy</topic><topic>Cholangiocarcinoma - diagnosis</topic><topic>Cholangiocarcinoma - mortality</topic><topic>Cholangiocarcinoma - therapy</topic><topic>Cholangiopancreatography, Endoscopic Retrograde</topic><topic>Cisplatin - administration & dosage</topic><topic>Contraindications</topic><topic>Deoxycytidine - administration & dosage</topic><topic>Deoxycytidine - analogs & derivatives</topic><topic>Drug therapy</topic><topic>Drug Therapy, Combination</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gastroenterology</topic><topic>Gemcitabine</topic><topic>Hepatectomy</topic><topic>Hepatic Artery</topic><topic>Humans</topic><topic>Injections, Intra-Arterial</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Organoplatinum Compounds - administration & dosage</topic><topic>Oxaliplatin</topic><topic>Retrospective Studies</topic><topic>Ribonucleotide Reductases - antagonists & inhibitors</topic><topic>Surgery</topic><topic>Survival Rate</topic><topic>Time Factors</topic><topic>Tomography, X-Ray Computed</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gusani, Niraj J.</creatorcontrib><creatorcontrib>Balaa, Fady K.</creatorcontrib><creatorcontrib>Steel, Jennifer L.</creatorcontrib><creatorcontrib>Geller, David A.</creatorcontrib><creatorcontrib>Marsh, J. Wallis</creatorcontrib><creatorcontrib>Zajko, Albert B.</creatorcontrib><creatorcontrib>Carr, Brian I.</creatorcontrib><creatorcontrib>Gamblin, T. Clark</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Journal of gastrointestinal surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gusani, Niraj J.</au><au>Balaa, Fady K.</au><au>Steel, Jennifer L.</au><au>Geller, David A.</au><au>Marsh, J. Wallis</au><au>Zajko, Albert B.</au><au>Carr, Brian I.</au><au>Gamblin, T. Clark</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment of Unresectable Cholangiocarcinoma with Gemcitabine-Based Transcatheter Arterial Chemoembolization (TACE): A Single-Institution Experience</atitle><jtitle>Journal of gastrointestinal surgery</jtitle><stitle>J Gastrointest Surg</stitle><addtitle>J Gastrointest Surg</addtitle><date>2008</date><risdate>2008</risdate><volume>12</volume><issue>1</issue><spage>129</spage><epage>137</epage><pages>129-137</pages><issn>1091-255X</issn><eissn>1873-4626</eissn><abstract>Background
Survival for patients with unresectable cholangiocarcinoma is reported to range from only 5–8 months without treatment. Systemic chemotherapy has not been shown to significantly improve survival, but newer regimens involving gemcitabine have shown increased response rates. Transcatheter arterial chemoembolization (TACE) has been shown to prolong survival in hepatocellular carcinoma patients, but experience using TACE in the treatment of cholangiocarcinoma is limited. We report our experience treating cholangiocarcinoma with TACE using chemotherapeutic regimens based on the well-tolerated drug gemcitabine.
Methods
Forty-two patients with unresectable cholangiocarcinoma were treated with one or more cycles of gemcitabine-based TACE at our institution. Chemotherapy regimens used for TACE included: gemcitabine only (
n
= 18), gemcitabine followed by cisplatin (
n
= 2), gemcitabine followed by oxaliplatin (
n
= 4), gemcitabine and cisplatin in combination (
n
= 14), and gemcitabine and cisplatin followed by oxaliplatin (
n
= 4).
Results
Patients were 59 years of age (range 36–86) and received a median of 3.5 TACE treatments (range 1–16). Thirty-seven patients (88%) had central cholangiocarcinoma, and five (12%) had peripheral tumors. Nineteen patients (45%) had extrahepatic disease. Grade 3 adverse events (AEs) after TACE treatments were seen in five patients, whereas grade 4 AEs occurred in two patients. No patients died within 30 days of TACE. Median survival from time of first treatment was 9.1 months overall. Results did not vary by patient age, sex, size of largest initial tumor, or by the presence of extra-hepatic disease. Treatment with gemcitabine–cisplatin combination TACE resulted in significantly longer survival (13.8 months) compared to TACE with gemcitabine alone (6.3 months).
Conclusions
Our report represents the largest series to date regarding hepatic-artery-directed therapy for unresectable cholangiocarcinoma and provides evidence in favor of TACE as a promising treatment modality in unresectable cholangiocarcinoma. Our results suggest that gemcitabine-based TACE is well tolerated and confers better survival when given in combination therapy (with cisplatin or oxaliplatin) for patients with unresectable cholangiocarcinoma.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>17851723</pmid><doi>10.1007/s11605-007-0312-y</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1091-255X |
| ispartof | Journal of gastrointestinal surgery, 2008, Vol.12 (1), p.129-137 |
| issn | 1091-255X 1873-4626 |
| language | eng |
| recordid | cdi_proquest_journals_1112236777 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adult Aged Aged, 80 and over Antineoplastic Agents - administration & dosage Bile Duct Neoplasms - diagnosis Bile Duct Neoplasms - mortality Bile Duct Neoplasms - therapy Bile Ducts, Intrahepatic Biopsy Chemoembolization, Therapeutic - methods Chemotherapy Cholangiocarcinoma - diagnosis Cholangiocarcinoma - mortality Cholangiocarcinoma - therapy Cholangiopancreatography, Endoscopic Retrograde Cisplatin - administration & dosage Contraindications Deoxycytidine - administration & dosage Deoxycytidine - analogs & derivatives Drug therapy Drug Therapy, Combination Female Follow-Up Studies Gastroenterology Gemcitabine Hepatectomy Hepatic Artery Humans Injections, Intra-Arterial Magnetic Resonance Imaging Male Medicine Medicine & Public Health Middle Aged Neoplasm Staging Organoplatinum Compounds - administration & dosage Oxaliplatin Retrospective Studies Ribonucleotide Reductases - antagonists & inhibitors Surgery Survival Rate Time Factors Tomography, X-Ray Computed Treatment Outcome |
| title | Treatment of Unresectable Cholangiocarcinoma with Gemcitabine-Based Transcatheter Arterial Chemoembolization (TACE): A Single-Institution Experience |
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