Kuhn Roger, Hribaschek Arndt, Eichelmann Katrin, Rudolph Stephan, Fahlke Joerg, Ridwelski Karsten
Clinic for General, Viscera and Vessel Surgery, Otto-von-Guericke-University, Magdeburg, Germany.
Invest New Drugs. 2002 Aug;20(3):351-6. doi: 10.1023/a:1016209901417.
The prognosis of patients with biliary tree carcinomas is very poor. The diagnosis often occurs at an advanced stage, when curative resection is not possible. We combined gemcitabine and docetaxel to optimize the palliative therapy for patients with gallbladder, biliary, and cholangio-carcinomas on an outpatient basis.
Patients with histologically proven biliary tree carcinomas and a WHO performance status <2 received gemcitabine 1000 mg/m2 followed by docetaxel 35 mg/m2 weekly for 3 weeks followed by I week of rest.
Forty-three patients, 14 males/29 females, with an average age of 63.3 years (range, 41 to 78) have been enrolled since 1998; 37 have completed treatment. So far, 168 cycles (range, 1 to 16) have been administered. All 43 patients were included in the response and toxicity assessments. There are no complete remissions; however, 4 (9.3%) patients achieved partial remission, 1 (2.3%) had a minimal remission, and 24 (55.8%) reached disease stabilization for a median period of 5.2 months. Fourteen (32.6%) patients progressed. The median overall survival rate is currently 11.0 months. Grade 3 hematologic toxicities were infrequent, and there were no grade 4 hematologic toxicities. Grade 3 leukopenia was reported in 4 (9.3%) patients, grade 3 thrombozytopenia in 1 (2.3%) patient, and grade 3 anemia in 1 (2.3%) patient. Twenty-eight (65.1%) patients had grade 3/4 alopecia, 8 (18.6%) had nausea/vomiting, and 2 (4.6%) had mucositis.
The combination of gemcitabine/docetaxel is an effective and well tolerated therapy for patients with advanced or metastatic gallbladder, biliary, and cholangio-carcinomas.
胆管癌患者的预后非常差。诊断通常在晚期进行，此时无法进行根治性切除。我们将吉西他滨和多西他赛联合使用，以优化对胆囊癌、胆管癌和胆管上皮癌患者的门诊姑息治疗。
组织学确诊为胆管癌且世界卫生组织体能状态评分<2的患者，接受吉西他滨1000mg/m²治疗，随后每周接受多西他赛35mg/m²治疗，共3周，之后休息1周。
自1998年以来，共纳入43例患者，其中男性14例/女性29例，平均年龄63.3岁（范围41至78岁）；37例完成治疗。迄今为止，已进行了168个周期（范围1至16个周期）的治疗。所有43例患者均纳入疗效和毒性评估。无完全缓解病例；然而，4例（9.3%）患者达到部分缓解，1例（2.3%）有微小缓解，24例（55.8%）病情稳定，中位稳定期为5.2个月。14例（32.6%）患者病情进展。目前中位总生存率为11.0个月。3级血液学毒性不常见，无4级血液学毒性。4例（9.3%）患者报告有3级白细胞减少，1例（2.3%）患者有3级血小板减少，1例（2.3%）患者有3级贫血。28例（65.1%）患者有3/4级脱发，8例（18.6%）有恶心/呕吐，2例（4.6%）有口腔炎。
吉西他滨/多西他赛联合方案是晚期或转移性胆囊癌、胆管癌和胆管上皮癌患者的一种有效且耐受性良好的治疗方法。
