Tugba Kos F, Aksoy S, Odabas H, Ozdemir N, Oksuzoglu B, Uncu D, Zengin N
Ankara Numune Education and Research Hospital, Department of Medical Oncology, Ankara, Turkey.
J BUON. 2011 Jul-Sep;16(3):464-8.
To study the efficacy of adjuvant therapy (chemotherapy and radiotherapy) in early stages (I-III) of gallbladder and bile duct cancers.
The clinical and pathological characteristics, treatment details and survival data of patients operated with early stages (I-III) of gallbladder and bile duct cancers and followed up in our clinic between August 2002 - November 2009 were retrospectively evaluated.
52 patients (median age 64 years) with early stages of gallbladder (n=36) and bile duct (n=16) cancers were analysed. Twenty-three (44.2%) patients had stage I, 23 (44.2%) stage II, and 6 (11.5%) stage III cancers. Approximately half of the patients (n=25; 48.1%) received postoperative adjuvant chemotherapy and/or radiotherapy. Patients with adjuvant treatment were younger than those without (62 vs. 71 years, p=0.06). Eighteen patients received chemotherapy alone, 2 chemotherapy followed by radiotherapy, 1 chemotherapy concurrently with radiotherapy, and 4 radiotherapy alone as adjuvant therapy. The regimen most frequently used (57.1%) was CFF (cisplatin 50 mg/m(2), day 1; folinic acid 200 mg/m(2), day 1; 5-fluorouracil [5-FU] 400 mg/m(2) bolus day 1 and 1600 mg/m(2) 48h continuous infusion). Some poor prognostic factors like high tumor grade and vascular invasion were more frequent in patients who received adjuvant therapy. The median disease free survival (DFS) was 11.4 months for the patients that received adjuvant therapy vs. 8.2 months for those without adjuvant therapy (p=0.67). During follow up 11 patients (44.0%) with adjuvant therapy and 12 (44.4%) without have died (p=0.97). The estimated median survival was 29 months.
Although previous studies had shown that 5-FU-based adjuvant chemotherapy may provide a small survival advantage, this was not confirmed in the present study. Prospective adjuvant trials with a standard chemotherapy regimen and larger numbers of patients are required.
研究辅助治疗（化疗和放疗）在胆囊癌和胆管癌早期（I - III期）的疗效。
回顾性评估2002年8月至2009年11月间在我院接受手术治疗并随访的胆囊癌和胆管癌早期（I - III期）患者的临床和病理特征、治疗细节及生存数据。
分析了52例早期胆囊癌（n = 36）和胆管癌（n = 16）患者（中位年龄64岁）。23例（44.2%）患者为I期，23例（44.2%）为II期，6例（11.5%）为III期癌症。约一半患者（n = 25；48.1%）接受了术后辅助化疗和/或放疗。接受辅助治疗的患者比未接受辅助治疗的患者年轻（62岁对71岁，p = 0.06）。18例患者仅接受化疗，2例先化疗后放疗，1例化疗与放疗同时进行，4例仅接受放疗作为辅助治疗。最常使用的方案（57.1%）是CFF（顺铂50mg/m²，第1天；亚叶酸钙200mg/m²，第1天；5-氟尿嘧啶[5-FU]400mg/m²静脉推注第1天和1600mg/m²持续输注48小时）。一些不良预后因素如高肿瘤分级和血管侵犯在接受辅助治疗的患者中更常见。接受辅助治疗的患者中位无病生存期（DFS）为11.4个月，未接受辅助治疗的患者为8.2个月（p = 0.67）。随访期间，接受辅助治疗的11例患者（44.0%）和未接受辅助治疗的12例患者（44.4%）死亡（p = 0.97）。估计中位生存期为29个月。
尽管先前的研究表明基于5-FU的辅助化疗可能提供微小的生存优势，但本研究未证实这一点。需要进行采用标准化疗方案且纳入更多患者的前瞻性辅助试验。
