Which hospital provides chemotherapy for gallbladder cancer?

The prognosis of gallbladder cancer is very poor, with an overall 5-year survival rate of less than 5%. This is mainly related to the high malignancy of the tumor, early metastasis and spread, and low early diagnosis rate and surgical resection rate. As mentioned earlier, the effect of tumor treatment is closely related to the staging of gallbladder cancer. Patients with stage I and II gallbladder cancer who are accidentally discovered after cholecystectomy for benign gallbladder disease can often survive for a long time, and the 5-year survival rate is reported to be 70%; on the contrary, the prognosis of cases above stage III is very poor. If the tumor has invaded the entire layer of the gallbladder, almost all patients will die within 2.5 years after surgery.

Gallbladder cancer is insensitive to various chemotherapy drugs and is mostly used for adjuvant treatment after surgery. There is currently no unified chemotherapy regimen, and the chemotherapy regimens that have been used are not ideal. By measuring the P-glycoprotein content of normal gallbladder and gallbladder cancer specimens, it was found that the gallbladder itself is an organ rich in P-glycoprotein, so it is necessary to reasonably select chemotherapy drugs. Commonly used chemotherapy drugs include fluorouracil (5-FU), cyclohexylnitrosourea (Me-CCNU), doxorubicin (adriamycin), mitomycin, carmustine (carbazine), etc. Combined use has a certain effect and can be tried when there is no other choice.

At present, the FAM regimen (1.0 g fluorouracil, 40 mg doxorubicin, 20 mg mitomycin) and FMP regimen (1.0 g fluorouracil, 10 mg mitomycin, 500 mg carboplatin) are mostly used for gallbladder cancer. A multicenter randomized clinical study using the FAM regimen abroad showed that for gallbladder cancer patients who have lost the opportunity for surgery, chemotherapy can significantly reduce the tumor volume, prolong the survival period, and even a small number of cases can achieve complete remission. Selective arterial catheterization and infusion of chemotherapy drugs can reduce systemic toxic reactions. Generally, during surgery, a catheter is placed from the right gastroepiploic artery into the hepatic artery, and a drug pump is buried subcutaneously. After the incision heals, the FMP regimen is selected and repeated every 4 weeks according to the condition. In addition, iodized oil (with chemotherapy drugs added) is injected through the portal vein, so that its particles can fully enter the liver sinusoids, which can play a role in local chemotherapy and temporarily block the tumor spread pathway. The clinical application has achieved certain results and provided a feasible treatment for patients with unresectable gallbladder cancer accompanied by liver metastasis. Intraperitoneal infusion of cisplatin and 5-FU has a certain effect on the prevention and treatment of peritoneal implantation and metastasis of gallbladder cancer. Currently, research on the combined chemotherapy of 5-FU, levamisole and folic acid is underway, and is expected to achieve good results.

Gallbladder cancer is not insensitive to various chemotherapy drugs, and it is difficult to observe its efficacy. However, with the continuous development of chemotherapy drugs and a large number of clinical studies in recent years, chemotherapy has a certain effect on patients who undergo radical surgery, those who cannot undergo surgery, or those who have relapsed after surgery.