Systemic Gemcitabine Combined with Hepatic Arterial Infusion Chemotherapy with Cisplatin, 5-Fluorouracil, and Isovorin for the Treatment of Advanced Intrahepatic Cholangiocarcinoma: A Pilot Study
Systemic Gemcitabine Combined with Hepatic Arterial Infusion Chemotherapy with Cisplatin, 5-Fluorouracil, and Isovorin for the Treatment of Advanced Intrahepatic Cholangiocarcinoma: A Pilot Study
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DOI：
10.5754/hge13455
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发表时间：
2014-01-01
影响因子：
--
通讯作者：
Sakaida, Isao
中科院分区：
文献类型：
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作者：
Marumoto, Miho;Yamasaki, Takahiro;Sakaida, Isao
背景/目的：肝内胆管细胞癌(ICC)预后较差，通常表现为晚期疾病。肝动脉灌注化疗(HAIC)是治疗中晚期肝细胞癌的一种很有前途的选择，然而，HAIC在肝细胞癌患者中的应用报道较少。在本研究中，我们观察了全身吉西他滨(GEM)联合HAIC联合顺铂(CDDP)、5-氟尿嘧啶(5-FU)和异鸟苷(Iovorin)治疗晚期ICC的疗效。方法：7例晚期肝细胞癌患者接受全身GEM联合HAIC联合顺铂、5-FU、异鸟苷治疗。结果：首次化疗有效率为57.1%，其中部分缓解4例，稳定2例，进展1例。1、2年累积生存率分别为85.7%和28.6%，中位生存期为22.3个月。3、4级不良反应发生率分别为：白细胞减少28.6%、中性粒细胞减少28.6%、血小板减少42.9%、贫血14.3%、厌食14.3%。没有遇到与治疗有关的死亡。结论：虽然这是一项初步研究，但我们认为全身GEM联合HAIC联合顺铂、5-FU和异鸟苷治疗晚期ICC可能是一种有效的治疗方法。
Background/Aims: Intrahepatic cholangiocarcinoma (ICC) has a poor prognosis and usually presents as advanced disease. Hepatic arterial infusion chemotherapy (HAIC) is a promising option for advanced hepatocellular carcinoma; however, there have been few reports on the use of HAIC in patients with ICC. In the present study, we investigated the efficacy of treatment with systemic gemcitabine (GEM) combined with HAIC with cisplatin (CDDP), 5-fluorouracil (5-FU), and isovorin in patients with advanced ICC. Methodology: Seven patients with advanced ICC, who received systemic GEM combined with HAIC with CDDP, 5-FU, and isovorin were studied. Results: The response rate after the first chemotherapy cycle was 57.1% (partial response, 4; stable disease, 2; progressive disease, 1). The cumulative survival rates at 1 and 2 years were 85.7% and 28.6%, respectively, and the median survival time was 22.3 months. With regard to grade 3 or 4 adverse reactions, the percentages of patients developing leukopenia, neutropenia, thrombocytopenia, anemia, and anorexia were 28.6%, 28.6%, 42.9%, 14.3%, and 14.3%, respectively. No treatment-related deaths were encountered. Conclusions: Although this is a pilot study, we suggest that systemic GEM combined with HAIC with CDDP, 5-FU, and isovorin, may be a useful therapy for patients with advanced ICC.