Palliative treatment of advanced gallbladder carcinoma        HU Zhi-qian, YAO Hou-shan. Department of General Surgery, Shanghai Changzheng Hospital, the Second Military Medical University，Shanghai 200003, China
Corresponding author: HU Zhi-qian, E-mail:huzq62@163.com
Abstract Gallbladder carcinoma (GBC) is often at an advanced stage when diagnosis is made. The majority of patients with advanced GBC have been unresectable, and overall prognosis in patients with GBC is dismally poor. The palliative treatment of gallbladder carcinoma from palliative operation, adjuvant chemotherapy, adjuvant radiation therapy and traditional Chinese drug is studied. Draining bile is the major reason for palliative operation in patients with gallbladder carcinoma, and internal drainage should be the primary option. Adjuvant radiation therapy is beneficial for gallbladder carcinoma with regional infiltration or lymph metastasis. The control of tumor progression is determined by radiation dosage. Intensity-modulated radiation therapy leads to less toxicity with the same effect. Adjuvant chemotherapy regime of gallbladder carcinoma should include Gemcitabine. The curative effect of Gemcitabine will enhance if it combined with platinums or adriamycin. The molecular target therapy of gallbladder carcinoma is at initial stage with no agent recommended at present. In conclusion, study of palliative treatment of gallbladder carcinoma remains limited. More multicentre prospective studies are needed to asses the adjuvant treatments of gallbladder carcinoma.