Combined treatment options for resectable common bile duct cancer patients

This article demonstrates a review of scientific works enlightened to combined treatment options for common bile duct cancer patients. The role of adjuvant therapy is highlighted. It has been shown that only capecitabine can be routinely prescribed in the postoperative period: median survival rate in general group of patients consisted 51 month versus 36 month in control group, (p = 0.028). Neoadjuvant chemotherapy for common bile duct cancer patients is still less studied and the research works results are mostly negative. At present, preoperative chemotherapy for patients with primary resectable tumors should not be applied currently excepting the scientific research protocol boundaries. A new chemotherapy regimen including gemcitabine, cisplatine and nab-paclitaxel has appeared which demonstrates a partial response to therapy reaching 45% for the patients with unresectable biliary cancer. The data of the retrospective study showing the positive role of neoadjuvant radiotherapy combined with gemcitabine: 70% of patients had a partial response as well as reliable improvement of recurrence-free (p = 0.0263) and overall (p = 0.00187) survival rates was observed compared to the group of patients who had no neoadjuvant therapy. The necessity of search for new additional treatment options for the common bile duct cancer patients in preoperative and postoperative period leaves no doubt.

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