Đang chuẩn bị liên kết để tải về tài liệu:
Diseases of the Gallbladder and Bile Ducts - part 6

Trong một nghiên cứu giai đoạn II bao gồm ung thư đường mật hoặc ung thư tế bào gan (mặc dù bệnh nhân đã không được chọn trên cơ sở biểu hiện EGFR), erlotinib đã được đưa ra liên tục ở một liều 150 mg / ngày bằng đường uống. | 212 Section 2 Diagnostic and therapeutic approaches for the biliary tree and gallbladder as erlotinib OSI-774 Tarceva have been evaluated in biliary cancers 71 . In a phase II study that included biliary cancer or hepatocellular cancer although patients were not selected on the basis of EGFR expression erlotinib was given continuously at a dose of 150 mg day orally. Of the 36 evaluable patients with biliary tumors two had a partial response and seven 25 were progression-free at 6 months. Conclusions Currently available medical approaches to the treatment of biliary malignancy are primarily palliative in intent. Chemotherapy appears to have a palliative benefit compared with the best supportive care in advanced gallbladder and bile duct cancers. When used as a radiosensitizer 5-fluorouracil may also give palliative benefit for locally advanced neoplasia. The role of chemotherapy in the adjuvant setting after surgical resection remains to be defined. Nevertheless we have typically combined adjuvant chemotherapy with radiation in patients with positive margins or regional lymph node involvement. For patients with locally advanced disease who would be surgical candidates if they attained tumor regression we use systemic chemotherapy as part of a neoadjuvant multimodality approach. As immune gene an-tiangiogenic and apoptotic strategies undergo further development they will likely be applied to biliary cancers. Questions 1. Gallbladder cancer is more likely than hilar cholangiocarcinoma to recur with distant disease. a. true b. false 2. Gemcitabine-containing chemotherapy regimens have among the highest response rates in gallbladder cancer. a. true b. false 3. There is a trend for better survival in patients with unresectable biliary malignancies who receive systemic chemotherapy compared with best supportive care. a. true b. false c. may be true but did not reach statistical significance 4. Pathways that may be involved in biliary malignancies include ErbB-2 hepatocyte