Cholangiocarcinoma medical therapy: Difference between revisions

Jump to navigation Jump to search
No edit summary
 
(5 intermediate revisions by 2 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Cholangiocarcinoma}}
{{Cholangiocarcinoma}}
{{CMG}};{{AE}} {{PSK}}
{{CMG}};{{AE}} {{F.K}}, {{PSK}}
==Overview==
==Overview==
Chemotherapy is indicated for unresectable cholangiocarcinoma as [[palliation|palliative chemotherapy]]. Chemotherapy agents used to treat cholangiocarcinoma include [[5-fluorouracil]], [[gemcitabine]], [[irinotecan]], [[cisplatin]], or [[doxorubicin]].
Chemotherapy is indicated for unresectable cholangiocarcinoma as [[palliation|palliative chemotherapy]]. Chemotherapy agents used to treat cholangiocarcinoma include [[5-fluorouracil]], [[gemcitabine]], [[irinotecan]], [[cisplatin]], or [[doxorubicin]].
Line 8: Line 8:
===Chemotherapy===
===Chemotherapy===
* 1.'''Chemotherapy'''  
* 1.'''Chemotherapy'''  
** Preferred regimen (1): 5-fluorouracil 600 mg/m2 with leucovorin 400 mg/m2 over 2 hours once every 2 weeks <ref name="pmid23919111">{{cite journal |vauthors=Ramírez-Merino N, Aix SP, Cortés-Funes H |title=Chemotherapy for cholangiocarcinoma: An update |journal=World J Gastrointest Oncol |volume=5 |issue=7 |pages=171–6 |year=2013 |pmid=23919111 |pmc=3731530 |doi=10.4251/wjgo.v5.i7.171 |url=}}</ref>  
** Preferred regimen (1): [[5-fluorouracil]] 600 mg/m2 with [[leucovorin]] 400 mg/m2 over 2 hours once every 2 weeks <ref name="pmid23919111">{{cite journal |vauthors=Ramírez-Merino N, Aix SP, Cortés-Funes H |title=Chemotherapy for cholangiocarcinoma: An update |journal=World J Gastrointest Oncol |volume=5 |issue=7 |pages=171–6 |year=2013 |pmid=23919111 |pmc=3731530 |doi=10.4251/wjgo.v5.i7.171 |url=}}</ref>  
** Alternative regimen (2): Gemcitabine 1,000 mg/m2 plus cisplatin<ref name="pmid15800324">{{cite journal |vauthors=Knox JJ, Hedley D, Oza A, Feld R, Siu LL, Chen E, Nematollahi M, Pond GR, Zhang J, Moore MJ |title=Combining gemcitabine and capecitabine in patients with advanced biliary cancer: a phase II trial |journal=J. Clin. Oncol. |volume=23 |issue=10 |pages=2332–8 |year=2005 |pmid=15800324 |doi=10.1200/JCO.2005.51.008 |url=}}</ref>
** Alternative regimen (2): [[Gemcitabine]] 1,000 mg/m2 plus cisplatin <ref name="pmid15800324">{{cite journal |vauthors=Knox JJ, Hedley D, Oza A, Feld R, Siu LL, Chen E, Nematollahi M, Pond GR, Zhang J, Moore MJ |title=Combining gemcitabine and capecitabine in patients with advanced biliary cancer: a phase II trial |journal=J. Clin. Oncol. |volume=23 |issue=10 |pages=2332–8 |year=2005 |pmid=15800324 |doi=10.1200/JCO.2005.51.008 |url=}}</ref>
** Alternative regimen (3): Irinotecan 125 mg/m2 q14 days
** Alternative regimen (3): [[Irinotecan]] 125 mg/m2 q14 days
** Alternative regimen (4): Oxaliplatin 400 mg/m2<ref name="pmid15319238">{{cite journal |vauthors=André T, Tournigand C, Rosmorduc O, Provent S, Maindrault-Goebel F, Avenin D, Selle F, Paye F, Hannoun L, Houry S, Gayet B, Lotz JP, de Gramont A, Louvet C |title=Gemcitabine combined with oxaliplatin (GEMOX) in advanced biliary tract adenocarcinoma: a GERCOR study |journal=Ann. Oncol. |volume=15 |issue=9 |pages=1339–43 |year=2004 |pmid=15319238 |doi=10.1093/annonc/mdh351 |url=}}</ref>
** Alternative regimen (4): [[Oxaliplatin]] 400 mg/m2 <ref name="pmid15319238">{{cite journal |vauthors=André T, Tournigand C, Rosmorduc O, Provent S, Maindrault-Goebel F, Avenin D, Selle F, Paye F, Hannoun L, Houry S, Gayet B, Lotz JP, de Gramont A, Louvet C |title=Gemcitabine combined with oxaliplatin (GEMOX) in advanced biliary tract adenocarcinoma: a GERCOR study |journal=Ann. Oncol. |volume=15 |issue=9 |pages=1339–43 |year=2004 |pmid=15319238 |doi=10.1093/annonc/mdh351 |url=}}</ref>
** Alternative regimen (5): Doxorubicin 60-75 mg/m2 q21 days
** Alternative regimen (5): [[Doxorubicin]] 60-75 mg/m2 q21 days <ref name="pmid11705850">{{cite journal |vauthors=Patt YZ, Hassan MM, Lozano RD, Waugh KA, Hoque AM, Frome AI, Lahoti S, Ellis L, Vauthey JN, Curley SA, Schnirer II, Raijman I |title=Phase II trial of cisplatin, interferon alpha-2b, doxorubicin, and 5-fluorouracil for biliary tract cancer |journal=Clin. Cancer Res. |volume=7 |issue=11 |pages=3375–80 |year=2001 |pmid=11705850 |doi= |url=}}</ref>
** Alternative regimen (6): Capecitabine 650 mg/m2 q21 days for 2 weeks  
** Alternative regimen (6): [[Capecitabine]] 650 mg/m2 q21 days for 2 weeks  
** Alternative regimen (7): Erlotinib PO 100 mg/day
** Alternative regimen (7): [[Erlotinib]] PO 100 mg/day


===Regional therapies===
===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:<ref name="pmid22627601">{{cite journal |vauthors=Halappa VG, Bonekamp S, Corona-Villalobos CP, Li Z, Mensa M, Reyes D, Eng J, Bhagat N, Pawlik TM, Geschwind JF, Kamel IR |title=Intrahepatic cholangiocarcinoma treated with local-regional therapy: quantitative volumetric apparent diffusion coefficient maps for assessment of tumor response |journal=Radiology |volume=264 |issue=1 |pages=285–94 |year=2012 |pmid=22627601 |doi=10.1148/radiol.12112142 |url=}}</ref><ref name="pmid21460876">{{cite journal |vauthors=Patel T |title=Cholangiocarcinoma--controversies and challenges |journal=Nat Rev Gastroenterol Hepatol |volume=8 |issue=4 |pages=189–200 |year=2011 |pmid=21460876 |pmc=3888819 |doi=10.1038/nrgastro.2011.20 |url=}}</ref>
*Regional therapies is recommended among patients with small cholangiocarcinomas, when the general health condition of the patient does not allow a more aggressive treatment:<ref name="pmid22627601">{{cite journal |vauthors=Halappa VG, Bonekamp S, Corona-Villalobos CP, Li Z, Mensa M, Reyes D, Eng J, Bhagat N, Pawlik TM, Geschwind JF, Kamel IR |title=Intrahepatic cholangiocarcinoma treated with local-regional therapy: quantitative volumetric apparent diffusion coefficient maps for assessment of tumor response |journal=Radiology |volume=264 |issue=1 |pages=285–94 |year=2012 |pmid=22627601 |doi=10.1148/radiol.12112142 |url=}}</ref><ref name="pmid21460876">{{cite journal |vauthors=Patel T |title=Cholangiocarcinoma--controversies and challenges |journal=Nat Rev Gastroenterol Hepatol |volume=8 |issue=4 |pages=189–200 |year=2011 |pmid=21460876 |pmc=3888819 |doi=10.1038/nrgastro.2011.20 |url=}}</ref>
**Transarterial chemoembolization (TACE)
**[[Transcatheter arterial chemoembolization|Transarterial chemoembolization]] ([[Transcatheter arterial chemoembolization|TACE]])
**Radioembolization
**[[Therapeutic embolization|Radioembolization]]


===Photodynamic Therapy===
===Photodynamic Therapy===

Latest revision as of 15:43, 7 January 2019

Cholangiocarcinoma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Cholangiocarcinoma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Cholangiocarcinoma medical therapy On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Cholangiocarcinoma medical therapy

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Cholangiocarcinoma medical therapy

CDC on Cholangiocarcinoma medical therapy

Cholangiocarcinoma medical therapy in the news

Blogs on Cholangiocarcinoma medical therapy

Directions to Hospitals Treating Cholangiocarcinoma

Risk calculators and risk factors for Cholangiocarcinoma medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Farima Kahe M.D. [2], Suveenkrishna Pothuru, M.B,B.S. [3]

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

Regional therapies

Photodynamic Therapy

References

  1. Vauthey J, Blumgart L (1994). "Recent advances in the management of cholangiocarcinomas". Semin. Liver Dis. 14 (2): 109–14. PMID 8047893.
  2. Ramírez-Merino N, Aix SP, Cortés-Funes H (2013). "Chemotherapy for cholangiocarcinoma: An update". World J Gastrointest Oncol. 5 (7): 171–6. doi:10.4251/wjgo.v5.i7.171. PMC 3731530. PMID 23919111.
  3. Knox JJ, Hedley D, Oza A, Feld R, Siu LL, Chen E, Nematollahi M, Pond GR, Zhang J, Moore MJ (2005). "Combining gemcitabine and capecitabine in patients with advanced biliary cancer: a phase II trial". J. Clin. Oncol. 23 (10): 2332–8. doi:10.1200/JCO.2005.51.008. PMID 15800324.
  4. André T, Tournigand C, Rosmorduc O, Provent S, Maindrault-Goebel F, Avenin D, Selle F, Paye F, Hannoun L, Houry S, Gayet B, Lotz JP, de Gramont A, Louvet C (2004). "Gemcitabine combined with oxaliplatin (GEMOX) in advanced biliary tract adenocarcinoma: a GERCOR study". Ann. Oncol. 15 (9): 1339–43. doi:10.1093/annonc/mdh351. PMID 15319238.
  5. Patt YZ, Hassan MM, Lozano RD, Waugh KA, Hoque AM, Frome AI, Lahoti S, Ellis L, Vauthey JN, Curley SA, Schnirer II, Raijman I (2001). "Phase II trial of cisplatin, interferon alpha-2b, doxorubicin, and 5-fluorouracil for biliary tract cancer". Clin. Cancer Res. 7 (11): 3375–80. PMID 11705850.
  6. 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.
  7. 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.
  8. 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.
  9. 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.

Template:WH Template:WS