Concurrent chemoradiotherapy with doxifluridine and paclitaxel for extrahepatic bile duct cancer

Objectives: Bile duct cancer is a rare malignancy with poor prognosis. We sought to determine the efficacy of concurrent chemoradiotherapy with doxifluridine and paclitaxel for extrahepatic bile duct cancer. Methods: Nineteen patients with unresectable extrahepatic bile duct cancer received doxifluridine (600 mg/m(2)) daily, intravenous paclitaxel (50 mg/m(2)) weekly (before radiotherapy), and radiotherapy of 4500 cGy for approximately 5 weeks. Results: Local response rate which reflected the reopening of occluded bile duct was 89.5% (17 out of 19). In 6 cases (31.6%), overall response, which measured the change of tumor size, was achieved with this treatment. The longest survival time was 52 months, and median survival time was 14 months. One- and 2-year survival rates were 84.2% and 31.6%, respectively. One case of gastrointestinal bleeding and I case of grade III leukopenia occurred during the treatment. One patient could not finish the treatment because of poor general condition. Conclusions: Concurrent chemoradiotherapy with doxifluridine and paclitaxel seemed to produce a good clinical response without severe toxicity and improve survival rates in patients with extrahepatic bile duct cancer.