J.Jpn. Surg. Soc.. 98(5): 479-483, 1997

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Feature topic

CHEMOTHERAPY FOR PRIMARY BILE DUCT CANCER

The prognosis for patients with bile duct cancer (BDC) is still dismal, because of the high incidence of postresection recurrence and frequency of unresectable tumors. Chemotherapy has been applied over 20 years with anticipation of enhanced response rate together with minimal adverse effects and prolonged survival. Despite the scarcity of experiences with chemotherapy dedicated to BDC, some eflicacy of chemotherapy on BDC has been indicated by this review of the literature. Chiefly, the administered drugs to unresectable BDC were 5-fluorouracil (5-FU), adriamycin (ADM) and mitomycin-C (MMC). Systemic chemotherapy, employing those drugs as single agents or as a combination like FAM (5-FU+ADM+ MMC), was most commonly administered. The collective response rate was 18.6％ (13/70), including a higher response rate of 29％ (4/14) by FAM.
Regional chemotherapy by hepatic arterial infusion has been expected to be more effective from the view point of blood supply, however, only a few trials have been reported as long as BDC. The series from the literature show a collective response rate of 50％ (3/6) for hepatic arterial infusion therapy.
The total number of patients (n＝16) treated by intra-ductal chemotherapy is too small to estimate clinical efficacy despite a relatively high collective response rate of 43.8％ (7/16).
This paper should encourage further investigation of chemotherapy for BDC.

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