You must try new therapies like TACE. The leading expert is Dr. Andrew Kennedy at Wake Radiology in Cary, North Carolina. Also Davanat is a drug that increases the effectiveness of 5 FU dramatically and eliminates the side effects. I would also look into Tykerb. If your husband's cancer has not spread then contact Dr. William Chapman at washington University in St. Louis. They are doing a data collection study on this cancer with a liver transplant protocol developed at Mayo Clinic. Very impressive results but the tumor cannot have spread. Here is a recent artricle on TACE from another center.
| TACE with microspheres preloaded with irinotecan in cholangiocarcinoma. |
| Sub-category: | Multidisciplinary Treatment | | Category: | Pancreas, Small Bowel, and Hepatobiliary Tract | | Meeting: | 2007 Gastrointestinal Cancers Symposium |
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| Abstract No: | 223 |
| Author(s): | G. Fiorentini, C. Aliberti, M. Tilli, G. Benea |
| Abstract: | Introduction: Unresectable cholangiocarcinoma (UCH) carries a dismal prognosis, with median survival times ranging from 3 to 6 months from the time of diagnosis. Palliative therapies have been disappointing and have not been shown to significantly prolong survival. Conversely, TACE has been effective in prolonging the lives of patients with hepatocellular carcinoma but has been used not extensively against UCH. DC bead is new embolic microsphere product that is capable of being loaded with IRI just before administration in TACE procedure. Therefore, the purpose of the present study was to assess the safety and efficacy of this new embolic microspheres IRI loaded and administered as TACE in patients with UCH. Methods: Eight patients with UCH were observed and 7 accepted to be treated with one or more cycles of DC bead of IRI 100 mg-TACE between February 2006 and August 2006. Follow-up imaging was performed on all patients before, immediately after, and 4 weeks after each TACE procedure to determine tumor response and need for further treatment. Each patient received i.v hydration, antibiotics, and medications against nausea and pain before TACE. Survival was calculated with use of the Kaplan-Meier survival curve. Results: Response Rate of 100% followed RECIST criteria. All patients are alive, with a median survival of 6 months (range 2-8). The procedure was well tolerated by all the patients. Five cases experienced WHO grade 2 right abdominal upper quadrant pain (RAQUP) and grade 3 in 2 cases lasting 10 hours (range 3-24). All patients had grade 2 fever for 2 days (range 1-7) and nausea and vomiting grade 2 lasting 12 hours (range 3- 36). Other side effects were mild that quickly resolved with conservative therapy alone. No evidence of alopecia or marrow toxicity has been reported. Conclusions: The results suggest that TACE was effective at shrinkage of huge UCH and probably prolonging survival of patients even if our follow up is short. Therefore, for these patients, DC bead of IRI 100 mg-TACE may be an appropriate palliative therapy. |