Objective  To evaluate the efficacy of chemotherapy for advanced biliary tract carcinoma and the factors that influence survival.

  Methods  A total of 91 cases of advanced biliary tract carcinoma from January 2010 to April 2015 were enrolled in our study. The patients' characteristics, chemotherapy regimens, and effects were analyzed.

  Results  We enrolled 56 males and 35 females with a median age of 57 years. A total of 90 patients were assessable for their responses to first-line chemotherapy. A total of 69 patients received the GP regimen, whereas 21 patients received some other regimens. The disease control rate (DCR), median progression free survival (mPFS), and median overall survival (mOS) were 68.1% versus 52.4%, 5.10 months versus 2.50 months (P=0.025), and 13.00 months versus 7.20 months, respectively. Only 31 patients received S-1 based regimens, and 12 patients received some other regimens as second-line chemotherapy. The DCR, median PFS, and median OS showed no statistical differences. Only four patients received S-1 based regimen plus bevacizumab as second-line chemotherapy (median PFS 5.3 months; median OS 7 months). Hematological toxicity was the most common side effect in the first-line GP regimen. The side effects of the S-1 based chemotherapy regimen was relatively less.

  Conclusion  The GP regimen is an effective first-line chemotherapy for advanced biliary tract carcinoma, whereas S-1 appears as an effective second-line chemotherapy drug. Bevacizumab-based regimens may be effective and require further validation.