化疗+免疫治疗助力肝内胆管癌转化切除1例

摘要/Abstract

摘要： 肝内胆管癌恶性程度高、起病隐匿,多数患者初诊时已失去根治手术机会,预后极差。转化治疗是不可切除肝内胆管癌的重要治疗手段,为手术切除创造条件。本文报道1例60岁女性患者,初诊肿瘤体积巨大,紧贴下腔静脉,包绕门脉右支及肝右静脉,合并门脉癌栓,残肝体积不足,直接手术风险极高。患者先行胆道支架植入解除黄疸,后续接受 4 周期度伐利尤单抗联合吉西他滨 + 顺铂的化疗 + 免疫方案进行转化治疗。治疗后肿瘤明显退缩,侵犯程度减轻,经评估具备手术指征,遂行右半肝+全尾叶切除联合区域淋巴结清扫术。术后继续行化疗+免疫辅助治疗及单纯免疫巩固治疗,随访截至2025年12月,患者无复发转移,肿瘤标志物恢复正常。该病例证实,化疗+免疫治疗方案用于肝内胆管癌转化治疗疗效确切,配合多学科诊疗,可有效实现肿瘤降期,提高根治切除率。

李荣轩, 陈晓, 王炳忱, 曹大勇, 周健国. 化疗+免疫治疗助力肝内胆管癌转化切除1例[J]. 肝癌电子杂志, 2026, 13(2): 26-32.

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