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局部晚期胆道癌中氟尿嘧啶或吉西他滨同步放化疗的疗效。

Efficacy of concurrent chemoradiotherapy with 5-fluorouracil or gemcitabine in locally advanced biliary tract cancer.

机构信息

Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.

出版信息

Cancer Chemother Pharmacol. 2014 Jan;73(1):191-8. doi: 10.1007/s00280-013-2340-5. Epub 2013 Dec 10.

Abstract

PURPOSE

There is no established standard treatment for patients with locally advanced biliary tract cancer (BTC).

METHODS

We analyzed the treatment results of locally advanced BTC from Jan 1995 to Dec 2010 at single institution of South Korea with retrospective study. One hundred and seventy-six patients were eligible to investigate the treatment response and toxicity. We treated these patients with 5-fluorouracil (5-FU)- or gemcitabine (GEM)-based concurrent chemoradiotherapy (CCRT) or best supportive care (BSC). The primary end point was overall survival.

RESULTS

Of these locally advanced BTC patients, 106 patients received CCRT and 70 patients were treated with BSC. The median overall survival was 42.57 weeks (95 % confidence interval [CI], 35.85-49.30) in CCRT group and 13.29 weeks (95 % CI 10.42-16.15) in BSC group (P < 0.001). Nausea and anemia were the most common toxicities observed.

CONCLUSIONS

Patients with locally advanced BTC who were treated with 5-FU-based or GEM-based CCRT seem to have a better survival than those who received BSC. The treatment-related toxicity was mild. GEM-based or 5-FU-based CCRT showed similar survival advantages.

摘要

目的

局部晚期胆道癌(BTC)患者尚无标准治疗方法。

方法

我们对韩国某单一机构 1995 年 1 月至 2010 年 12 月的局部晚期 BTC 患者的治疗结果进行了回顾性分析。共有 176 例患者符合调查治疗反应和毒性的条件。我们用 5-氟尿嘧啶(5-FU)或吉西他滨(GEM)为基础的同步放化疗(CCRT)或最佳支持治疗(BSC)对这些患者进行治疗。主要终点是总生存期。

结果

在这些局部晚期 BTC 患者中,106 例患者接受了 CCRT,70 例患者接受了 BSC。CCRT 组的中位总生存期为 42.57 周(95%置信区间[CI],35.85-49.30),BSC 组为 13.29 周(95%CI 10.42-16.15)(P<0.001)。最常见的毒性反应是恶心和贫血。

结论

接受 5-FU 或 GEM 为基础的 CCRT 治疗的局部晚期 BTC 患者的生存情况似乎优于接受 BSC 治疗的患者。治疗相关的毒性反应较轻。以 GEM 或 5-FU 为基础的 CCRT 显示出相似的生存优势。

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