Impressive Result of Gemcitabine and Cisplatin Combination Therapy in Post-Operative Residual Cholangiocarcinoma Patient Presenting with Hyperbilirubinemia, an Experience in Indonesian Tertiary Hospital

Ibnu Purwanto (Hematology and Medical Oncology Division, Internal Medicine Department, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital)
Agus Barmawi (Digestive Surgery Department, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital)
Bambang Purwanto Utomo (Radiology Department, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital)
Ahmad Ghozali (Anatomical Pathology Department, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital)

Acta Interna : The Journal of Internal Medicine
Vol 10, No 2 (2020): Acta Interna The Journal of Internal Medicine

Introduction: Cholangiocarcinoma (CCA) often presents at an inoperable or an advanced stage in which complete resection is not possible. In such scenario, chemotherapy often is the only option to improve patient’s survival. Severe hyperbilirubinemia, often associated with higher risk of developing chemotherapy-related adverse event, might complicates one’s decision in choosing chemotherapy regimen. Case Report: We present a case of 63-year-old post-operative CCA patient with residual mass and severe hyperbilirubinemia. The patient completed six cycles of gemcitabine (1000 mg/m2, day 1 and 8) and cisplatin (70 mg/m2, day 1) every 3 weeks with tolerable side effect. No sign of residual tumor was observed on CT-Scan performed one-month post chemotherapy. Conclusion: Combination of cisplatin and gemcitabine may offer safe treatment option for post-operative residual CCA patient presenting with hyperbilirubinemia.