title: Chemotherapy outcomes for the treatment of unresectable intrahepatic and hilar cholangiocarcinoma: a retrospective analysis.
abstract: BACKGROUND
  Recent clinical trials for "biliary cancers" include a heterogenous group of patients with cholangiocarcinoma, gallbladder, and ampullary cancers. Limited data exist regarding the relative effectiveness of known chemotherapeutic regimens specifically in intrahepatic or hilar cholangiocarcinoma.
  
  
  METHODS
  Records of M D Anderson Cancer Center patients with unresectable intrahepatic and hilar cholangiocarcinoma who received first-line chemotherapy from January 1, 2005, to October 31, 2009, were retrospectively reviewed. The primary objective of this research was to determine overall tumor control rates with chemotherapeutic regimens used for first-line treatment of unresectable intrahepatic and hilar cholangiocarcinoma. Secondary objectives included duration of response, overall survival, and prognostic factors.
  
  
  RESULTS
  Eighty-five patients met inclusion criteria and were eligible for analysis. The most commonly used regimen was gemcitabine/cisplatin (62%), followed by oxaliplatin and capecitabine (16%). There was no significant difference between tumor control rates with gemcitabine/cisplatin (72% PR + SD) and other regimens (69% PR + SD). There was no significant difference between overall survival with the use of gemcitabine/cisplatin (15.2 months) or alternative regimens (13.9 months). A decrease in overall survival was seen with elevated baseline CA 19-9 (p < .0001), an initial diagnosis of unknown primary tumor (p = .0001), and prior treatment with chemoradiation (p = .0018).
  
  
  CONCLUSIONS
  In this retrospective review, both gemcitabine/cisplatin and alternative doublets (including capecitabine/oxaliplatin, gemcitabine/capecitabine, and gemcitabine/oxaliplatin) were effective regimens in maintaining disease control in intrahepatic and hilar cholangiocarcinoma.
authors.forename: Karen R
authors.initials: KR
authors.lastname: Eckmann
authors.forename: Dina K
authors.initials: DK
authors.lastname: Patel
authors.forename: Andrea
authors.initials: A
authors.lastname: Landgraf
authors.forename: Julian H
authors.initials: JH
authors.lastname: Slade
authors.forename: E
authors.initials: E
authors.lastname: Lin
authors.forename: Harmeet
authors.initials: H
authors.lastname: Kaur
authors.forename: Evelyne
authors.initials: E
authors.lastname: Loyer
authors.forename: Jacqueline M
authors.initials: JM
authors.lastname: Weatherly
authors.forename: Milind
authors.initials: M
authors.lastname: Javle