Concurrent Chemoradiation in a Patient with Unresectable Cholangiocarcinoma
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Cholangiocarcinoma is a catastrophic tumor with a high mortality rate, for which surgery is the most reliable treatment. However, these tumors progress insidiously and are difficult to diagnose early. Most patients lack the opportunity to receive surgery due to the advanced disease stage at the time of the diagnosis,at which point only few alternative treatments are available. There is a need for more effective therapy to improve the survival or quality of life of these patients. The present case was a 73-year-old male who presented with jaundice and fatigue underwent CT imaging, in which a 3.5×4.0-cm low-attenuation mass was found in hepatic segment 4. Cholangiocarcinoma was diagnosed by cytological examination of the bile juice. A combination of CyberKnife radiosurgery and S-1 oral chemotherapy was performed. The patient was alive at a 8-month follow-up, and serial CT scans revealed a markedly regressed tumor. Therefore,we suggest that concurrent chemoradiation with the CyberKnife and S-1 is a treatment option for advanced cholangiocarcinoma.
Abstract
Cholangiocarcinoma is a catastrophic tumor with a high mortality rate, for which surgery is the most reliable treatment. However, these tumors progress insidiously and are difficult to diagnose early. Most patients lack the opportunity to receive surgery due to the advanced disease stage at the time of the diagnosis,at which point only few alternative treatments are available. There is a need for more effective therapy to improve the survival or quality of life of these patients. The present case was a 73-year-old male who presented with jaundice and fatigue underwent CT imaging, in which a 3.5×4.0-cm low-attenuation mass was found in hepatic segment 4. Cholangiocarcinoma was diagnosed by cytological examination of the bile juice. A combination of CyberKnife radiosurgery and S-1 oral chemotherapy was performed. The patient was alive at a 8-month follow-up, and serial CT scans revealed a markedly regressed tumor. Therefore,we suggest that concurrent chemoradiation with the CyberKnife and S-1 is a treatment option for advanced cholangiocarcinoma.
참고문헌 (9)
- Ustundag Y, "Cholangiocarcinoma: a compact review of the literature", World J Gastroenterol, 14, pp.6458~6466 (2008)
- Ben-David MA, "Externalbeam radiotherapy for localized extrahepatic cholangiocarcinoma", Int J Radiat Oncol Biol Phys, 66, pp.772~779 (2006)
- Kim MS, "Stereotactic body radiation therapy in patients with pelvic recurrence from rectal carcinoma", Jpn J Clin Oncol, 38, pp.695~700 (2008)
- Jarnagin WR, "Staging, resectability, and outcome in 225 patients with hilar cholangiocarcinoma", Ann Surg, 234, pp.507~517 (2001)
- Nakeeb A, "Cholangiocarcinoma: a spectrum of intrahepatic, perihilar, and distal tumors", Ann Surg, 224, pp.463~473 (1996)
- Killeen RP, "Achievable outcomes in the management of proximal cholangiocarcinoma: an update prepared using "evidence-based practice" techniques", Abdom Imaging, 33, pp.54~57 (2008)
- Foo ML, "External radiation therapy and transcatheter iridium in the treatment of extrahepatic bile duct carcinoma", Int J Radiat Oncol Biol Phys, 39, pp.929~935 (1997)
- Ortner ME, "Successful photodynamic therapy for nonresectable cholangiocarcinoma: a randomized prospective study", Gastroenterology, 125, pp.1355~1363 (2003)
- Matsuzaki Y, "Efficacy of proton irradiation for HCC", Nippon Rinsho, 59(Suppl. 6), pp.659~664 (2001)