title: Intrahepatic chemotherapy for unresectable cholangiocarcinoma:  review of literature and personal experience.
abstract: Most patients with intrahepatic cholangiocarcinoma (IH-CCA) are unresectable and treatment options are limited. This study evaluates the efficacy of hepatic artery infusion (HAI) chemotherapy in patients whose disease is not initially treatable with resection. We selected patients with unresectable IH-CCA treated only with HAI chemotherapy at our centre between January 2008 and December 2012. We compared our outcome, using mRECIST, with published results of patients treated with systemic chemotherapy during the same period. Eleven patients underwent HAI chemotherapy with fluorouracil and oxaliplatin after placement of an HAI pump. A CT scan performed after the sixth cycle of therapy revealed that 5 of them had partial hepatic response (more than 45 %), 2 stable disease and 4 showed clear signs of disease progression. The average survival of the entire group was 17.6 months. Three of the patients with partial hepatic response underwent resection and 2 had more than 70 % tumour necrosis, both of whom are still alive and disease free. The median survival of patients with liver-only disease treated with systemic chemotherapy, who were not submitted for resection, was 15.3 months. HAI chemotherapy enables this small group of patients to have their unresectable IH-CCA disease converted into a resectable one, thus confirming its role in treatment of this disease.
authors.forename: Marco
authors.initials: M
authors.lastname: Massani
authors.forename: Cristina
authors.initials: C
authors.lastname: Nistri
authors.forename: Cesare
authors.initials: C
authors.lastname: Ruffolo
authors.forename: Roberta
authors.initials: R
authors.lastname: Bonariol
authors.forename: Bruno
authors.initials: B
authors.lastname: Pauletti
authors.forename: Luca
authors.initials: L
authors.lastname: Bonariol
authors.forename: Ezio
authors.initials: E
authors.lastname: Caratozzolo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Morana
authors.forename: Nicolò
authors.initials: N
authors.lastname: Bassi
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001650:Bile Duct Neoplasms / Q000188:drug therapy* / Q000401:mortality; D018281:Cholangiocarcinoma / Q000188:drug therapy* / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage*; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage*; D000077150:Oxaliplatin; D012189:Retrospective Studies
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D005472:Fluorouracil