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Integrative Tumor Board: Cholangiocarcinoma

机译：综合肿瘤委员会：胆管癌

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Chief complaint: This is a 48-year-old man with advanced metastatic cholangiocarcinoma.In May 2003, the patient presented with pruritus and icteric sclera. A magnetic resonance image of the abdomen showed a 2.7 x 2.0 cm mass at the bifurcation of the biliary tree and extending to left liver lobe. There was occlusion of the left portal vein and involvement of a portion of the left hepatic artery. This was compatible with Klatskin tumor. Bilateral pleural effusions were also noted along with pancreatitis and enlarged lymph nodes. The patient underwent an endoscopy and ultrasound-guided fine needle aspiration. The left hilar biopsy was positive for adenocarcinoma and a background of extensive necrosis. The portal mass biopsy and acidic fluid were negative for malignancy.July 2003 to November 2003: Patient was enrolled in a clinical trial at the University of Chicago with BMS-247550. This was a 3-hour infusion he received every 3 weeks. His scans in August 2003 as well as September 2003 showed stability.November 2003: His computed tomography scan showed new right cardiophrenic adenopathy. All other findings were stable.November 2003 to January 2004: Patient received a chemotherapy protocol of CPT-11 and Gemzar administered weekly at the University of Chicago.January 2004: Patient presented at the Block Center seeking an integrative treatment program. The patient then switched his care to the Block Center for Integrative Cancer Care and was recommended to continue on CPT-11 125 mg per M2 and Gemzar 1.5 g given on days 1 and 15.
机译：主诉：这是一名48岁的晚期转移性胆管癌患者。2003年5月，患者出现瘙痒和黄疸性巩膜炎。腹部的磁共振图像显示胆管分支处有2.7 x 2.0 cm的肿块，并延伸到左肝叶。左门静脉闭塞，左肝动脉的一部分受累。这与Klatskin肿瘤相容。还注意到双侧胸腔积液以及胰腺炎和淋巴结肿大。患者接受了内窥镜检查和超声引导下的细针抽吸。左肺门活检为腺癌阳性，并有广泛的坏死背景。门静脉活检和酸性液体对恶性肿瘤呈阴性。2003年7月至2003年11月：患者使用BMS-247550在芝加哥大学进行了一项临床试验。他每3周接受3个小时的输液。他在2003年8月和2003年9月的扫描显示稳定。2003年11月：他的计算机断层扫描显示了新的右心肾上腺病变。所有其他发现均保持稳定.2003年11月至2004年1月：患者接受了CPT-11的化学治疗方案，Gemzar每周在芝加哥大学进行给药.2004年1月：患者在Block Center寻求综合治疗方案。然后，患者将其护理转到了综合癌症护理中心，建议在第1天和第15天继续服用CPT-11 125 mg / M2和Gemzar 1.5 g。

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