Kuriyama Hitoshi, Kawana Kenichi, Taniguchi Reo, Jono Fumitake, Sakai Eiji, Ohubo Hidenori, Suzuki Hirobumi, Kobayashi Satoshi, Murata Yoriko, Inamori Masahiho, Hata Yasuo, Nahajima Atsushi
Division of Gastroenterology, Chigasaki Municipal Hospital, Chigasaki-city, Kanagawa, Japan.
Hepatogastroenterology. 2011 Mar-Apr;58(106):270-4.
BACKGROUND/AIMS: This study examined the effect of systemic chemotherapy with gemcitabine (GEM) on survival in elderly patients (aged > or = 70 years) with unresectable biliary tract cancer as compared with best supportive care (BSC).
We conducted a retrospective study of consecutive patients with unresectable biliary tract cancer administered GEM (800-1,000 mg/m2) on days 1, 8 and 15 every 4 weeks as a first-line treatment. Eligibility included age 70 years and over, and bile duct carcinoma or gallbladder cancer.
Twenty-eight patients were enrolled: 13 (46.4%) received chemotherapy with GEM and 15 (53.6%) received BSC. No cases of complete or partial response were observed. Stable and progressive disease was observed in 9 (69.2%) and 2 patients (15.4%), respectively. Disease control rate was 69.2%. The median overall survival time of patients treated with GEM and BSC was 9.1 and 2.9 months, and the 1-year survival rates were 15.4% and 6.7%, respectively. Grade 3/4 neutropenia occurred in three (23.1%), leukopenia in two (15.4%) and anemia in one patient (7.7%). Grade 3 non-hematologic toxicities were constipation (7.7%) and fatigue (7.7%).
Chemotherapy with single-agent GEM is a safe and well tolerated regimen for elderly patients with unresectable biliary tract cancer.
背景/目的：本研究探讨了吉西他滨（GEM）全身化疗与最佳支持治疗（BSC）相比，对不可切除胆管癌老年患者（年龄≥70岁）生存的影响。
我们对连续的不可切除胆管癌患者进行了一项回顾性研究，这些患者每4周在第1、8和15天接受GEM（800 - 1000mg/m²）作为一线治疗。入选标准包括年龄70岁及以上，胆管癌或胆囊癌。
共纳入28例患者：13例（46.4%）接受GEM化疗，15例（53.6%）接受BSC。未观察到完全或部分缓解病例。分别有9例（69.2%）和2例（15.4%）患者病情稳定和进展。疾病控制率为69.2%。接受GEM和BSC治疗的患者中位总生存时间分别为9.1个月和2.9个月，1年生存率分别为15.4%和6.7%。3/4级中性粒细胞减少症发生在3例（23.1%）患者中，白细胞减少症发生在2例（15.4%）患者中，贫血发生在1例（7.7%）患者中。3级非血液学毒性为便秘（7.7%）和疲劳（7.7%）。
单药GEM化疗对不可切除胆管癌老年患者是一种安全且耐受性良好的治疗方案。
