Arterial infusion of cisplatin plus S-1 against unresectable intrahepatic cholangiocarcinoma.

Conventional regimens for unresectable intrahepatic cholangiocarcinoma are considered of limited effectiveness. To evaluate the efficacy and toxicity of combination chemotherapy with hepatic arterial infusion of IA-call (a fine-powder formulation of cisplatin) plus oral S-1 in patients with unresectable intrahepatic cholangiocarcinoma. The clinicopathological data and long-term outcome of 12 patients who were received with IA-call plus S-1 were compared with those of 16 patients who were received other treatments, such as radiation therapy, trans-arterial chemoembolization, and systemic chemotherapy. The IA-call plus S-1 regimen consisted of IA-call (65 mg/m2 , administered into the hepatic artery) on day 1 and oral S-1 (60 mg/m2 /day) on days 1-28, every 42 days, repeated cycle. Prognostic factors of these patients were evaluated by uni- and multivariate analysis. There was no significant difference between the two groups in the disease status, such as the number of tumor and the tumor size. The overall survival was significantly longer in the patients receiving the arterial IA-call and S-1 regimen (median survival time = 10.1; range, 3.6-24.2 months) than in the receiving other treatments (median survival time = 4.0; range; 0.3-24.2 months, p = 0.01). The multivariate analysis revealed that chemotherapy regimen was significantly related to survival, with a hazard ratio of 3.97 (p = 0.02). In the IA-call plus S-1 group, the overall response rate was 33.3%. The major toxic effect was grade 3 anemia, occurring in 1 patient (4.5%). Combination chemotherapy with arterial IA-call plus oral S-1 is an effective regimen that may improve survival in patients with unresectable intrahepatic cholangiocarcinoma.