CHEMOTHERAPY FOR UNRESECTABLE BILIARY CANCER: REVIEW

УДК 616.367-006.6:615.28

Abstract

Malignant tumors of the biliary ducts (BDC, biliary duct cancer) are rare cancers arising from the epithelium of the extrahepatic biliary tract, including intrahepatic and extrahepatic cholangiocarcinomas, as well as malignant tumors of the gallbladder and ampullae of the big duodenal papilla (BDP). The global and Russian incidence of these diseases is <1% of all cancer cases. Despite their rarity, BDC has one of the lowest five-year survival rates, second only to pancreatic head tumors. The lack of early symptoms leads to late diagnosis, with 80% of patients presenting with unresectable BDC or advanced disease, significantly impacting life expectancy and quality of life. Unresectable cholangiocarcinoma is primarily treated with chemotherapy, including systemic, targeted, and local invasive methods. However, obstructive jaundice and hepatorenal failure limit the use of aggressive chemotherapy in most patients, hindering the implementation of effective systemic protocols. While targeted chemotherapy shows promise due to the abundance of molecular targets in bile duct malignancies, its impact on complications is limited. Local chemotherapy directly affects tumor size, invasion, and bile duct lumen, but its clinical effectiveness and impact on overall survival remain inconclusive. The search for new local and systemic approaches to cholangiocarcinoma is promising, aiming to improve overall survival and address obstructive jaundice.