title: Successful treatment of unresectable gallbladder cancer with low-dose paclitaxel as palliative chemotherapy after failure of gemcitabine and oral S-1: A case report.
abstract: A 56-year-old female with metastatic gallbladder cancer involving the liver and stenosis of the hilar bile duct was treated with gemcitabine (1,000 mg/m(2)) plus S-1 (60 mg/m(2)). After 9 cycles of therapy, CT showed evidence of stable disease; however, the serum CEA level was increased. Therefore, the chemotherapy regimen was changed to weekly low-dose paclitaxel (60 mg/m(2)). After 12 cycles of therapy, paclitaxel was reduced to 30 mg/m(2) as the patient developed neutropenia. The patient completed 32 cycles of therapy, and the tumor was reduced in size and marked improvement in bile duct stenosis was noted without any impairment in quality of life. The patient succumbed to the disease 25 months after treatment was initiated. Thus, in this case paclitaxel was more effective than gemcitabine plus S-1. Palliative chemotherapy with paclitaxel after failure of gemcitabine and 5-FU was well-tolerated; therefore, it may be an effective treatment for biliary tract cancer (BTC). A phase I study of palliative chemotherapy with weekly low-dose paclitaxel following gemcitabine (plus cisplatin) and 5-FU is currently in progress in patients with unresectable or recurrent BTC.
authors.affiliation: Department of Gastroenterologic Surgery, Division of Cancer Medicine, Graduate School of Medical Science;
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Tajima
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ohta
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shinbashi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hirose
authors.forename: Tomoya
authors.initials: T
authors.lastname: Tsukada
authors.forename: Koichi
authors.initials: K
authors.lastname: Okamoto
authors.forename: Shinichi
authors.initials: S
authors.lastname: Nakanuma
authors.forename: Seisho
authors.initials: S
authors.lastname: Sakai
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Furukawa
authors.forename: Isamu
authors.initials: I
authors.lastname: Makino
authors.forename: Keishi
authors.initials: K
authors.lastname: Nakamura
authors.forename: Hironori
authors.initials: H
authors.lastname: Hayashi
authors.forename: Katsunobu
authors.initials: K
authors.lastname: Oyama
authors.forename: Masafumi
authors.initials: M
authors.lastname: Inokuchi
authors.forename: Hisatoshi
authors.initials: H
authors.lastname: Nakagawara
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Miyashita
authors.forename: Hideto
authors.initials: H
authors.lastname: Fujita
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takamura
authors.forename: Itasu
authors.initials: I
authors.lastname: Ninomiya
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Kitagawa
authors.forename: Sachio
authors.initials: S
authors.lastname: Fushida
authors.forename: Takashi
authors.initials: T
authors.lastname: Fujimura
authors.forename: Hisatsugu
authors.initials: H
authors.lastname: Mouri
authors.forename: Koushiro
authors.initials: K
authors.lastname: Ohtsubo