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Radiotherapy combined with transarterial infusion chemotherapy and concurrent infusion of a vasoconstrictor agent for nonresectable advanced hepatic hilar duct carcinoma
Article first published online: 26 APR 2004
Copyright © 2004 American Cancer Society
Volume 100, Issue 11, pages 2422–2429, 1 June 2004
How to Cite
Matsumoto, S., Kiyosue, H., Komatsu, E., Wakisaka, M., Tomonari, K., Hori, Y., Matsumoto, A. and Mori, H. (2004), Radiotherapy combined with transarterial infusion chemotherapy and concurrent infusion of a vasoconstrictor agent for nonresectable advanced hepatic hilar duct carcinoma. Cancer, 100: 2422–2429. doi: 10.1002/cncr.20265
- Issue published online: 18 MAY 2004
- Article first published online: 26 APR 2004
- Manuscript Accepted: 12 MAR 2004
- Manuscript Revised: 4 MAR 2004
- Manuscript Received: 19 SEP 2003
- bile duct carcinoma;
- hilar cholangiocarcinoma;
- intraarterial chemotherapy;
The treatment of patients with advanced hepatic hilar duct carcinoma is a challenging problem. The current study was performed to evaluate the outcome of patients with advanced hepatic hilar duct carcinoma who received external beam radiotherapy (EBRT) combined with transarterial chemotherapy and infusion of a vasoconstrictor.
Between April 1993 and December 2002, 23 patients with histopathologically confirmed hilar duct carcinoma entered the study. The median total dose of EBRT was 41.4 grays (Gy). Transarterial chemotherapy was performed twice during EBRT. It was comprised of an infusion of a cocktail of 20 mg of epirubicin, 10 mg of mitomycin C, and 500 mg of 5-fluorouracil and was administered 1 minute after injection of epinephrine via a catheter introduced in the hepatic arteries. After the combined treatment, the patients underwent biliary endoprosthesis after evaluation of the initial response to treatment by percutaneous transhepatic cholangiography (PTC). The initial responses based on PTC were classified into four categories: CR, no stenosis; PR, relief of stenosis/obstruction; NC, no change; and PD, progressive stenosis/obstruction. The outcome parameters were survival rates and time, as well as frequency and type of complications.
Excluding 1 patient who discontinued the treatment, the initial responses of 22 patients were 1 CR (5%), 8 PR (36%), 11 NC (50%), and 2 PD (9%). The response rate was 41%. The overall survival rates at 1 year, 2 years, and 3 years after treatment were 59%, 36%, and 18%, respectively.
The combination of radiotherapy, transarterial infusion chemotherapy, and concurrent infusion of a vasoconstrictor can be delivered safely with good efficacy for patients withadvanced hilar duct carcinoma. Cancer 2004. © 2004 American Cancer Society.