title: [Two cases of inoperable advanced bileduct cancer treated effectively with a gemcitabine/cisplatin combination].
abstract: We report two cases of inoperable advanced bileduct cancer that responded well to combined gemcitabine (GEM)/cisplatin (CDDP) therapy. A 70-year-old woman was admitted to the hospital because of jaundice; PTCD was performed, followed by laparotomy, however, the tumor was found to be inoperable because of extensive direct invasion of the surrounding organs. Then, after insertion of a stent, the patient was started on combined chemotherapy with GEM 1,000 mg/m2 on days 1, 8 and CDDP 70 mg/m2 on day 1 administered once every 3 weeks. After 4 courses, thrombocytopenia appeared. Therefore, chemotherapy was continued for another three courses with GEM 800 mg/m2 on days 1, 15 and CDDP 50 mg/m2 on day 1 every 4 weeks. After 7 courses the serum CEA level returned to normal range, and marked reduction of the tumor size was observed on CT. The patient has been able to maintain a good quality of life without occurrence of any severe adverse effects. A 61-year-old woman was admitted to the hospital because of icterus, and was diagnosed to have lower bile duct cancer with liver metastasis. After insertion of a stent, she was started on combined chemotherapy with GEM 1,000 mg/m2 on days 1, 8 and CDDP 70 mg/m2 on day 1 administered once every 3 weeks. After completion of 4 courses, the patient developed thrombocytopenia and a feel- ing of dullness. Therefore, chemotherapy was continued for the next three courses with GEM 800 mg/m2 on days 1, 15 and CDDP 50 mg/m2 on day 1, administered every 4 weeks. This treatment was associated with a fall of the serum CA19-9 level to within normal range, and marked improvement of the liver metastasis was also noted. Combined GEM/ CDDP therapy improves the QOL of inoperable bile duct cancer patients and offers promise as pre-operative chemotherapy.
authors.affiliation: Dept. of Surgery, Inagi Municipal Hospital.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Nakamura
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Junichi
authors.initials: J
authors.lastname: Saito
authors.forename: Ken
authors.initials: K
authors.lastname: Ikeda
authors.forename: Seijirou
authors.initials: S
authors.lastname: Okusawa
authors.forename: Santaro
authors.initials: S
authors.lastname: Sagae
authors.forename: Kenji
authors.initials: K
authors.lastname: Iwata
authors.forename: Eiji
authors.initials: E
authors.lastname: Kurihara
mesh_terms: D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001650:Bile Duct Neoplasms / Q000188:drug therapy* / Q000628:therapy; D002272:Carcinoembryonic Antigen / Q000097:blood; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D008875:Middle Aged; D015607:Stents; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D002272:Carcinoembryonic Antigen; D003841:Deoxycytidine; D002945:Cisplatin; D000093542:Gemcitabine