Kim Bum Jun, Yoo Changhoon, Kim Kyu-Pyo, Hyung Jaewon, Park Seong Joon, Ryoo Baek-Yeol, Chang Heung-Moon
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Seoul, Republic of Korea.
Br J Cancer. 2017 Feb 28;116(5):561-567. doi: 10.1038/bjc.2016.446. Epub 2017 Jan 12.
We aimed to assess the efficacy of second-line fluoropyrimidine-based chemotherapy in patients with advanced biliary tract cancer (BTC) after failure of gemcitabine plus cisplatin (GEMCIS).
We retrospectively examined patients with histologically documented advanced BTC who received first-line GEMCIS between December 2010 and June 2015. Among 748 patients treated with first-line GEMCIS, 321 (43%) subsequently received fluoropyrimidine-based second-line systemic chemotherapy.
Fluoropyrimidine monotherapy and fluoropyrimidine-platinum combination were used in 255 and 66 patients, respectively. In patients with measurable disease, the overall response rate (ORR) was 3% and disease control rate was 47%. After a median follow-up of 27.6 months (range, 0.9-70.4 months), the median progression-free survival (PFS) and overall survival (OS) were 1.9 months (95% confidence interval (CI), 1.6-2.2) and 6.5 months (95% CI, 5.9-7.0), respectively. The ORR was significantly higher in patients who received fluoropyrimidine-platinum combination compared with those who received fluoropyrimidine alone (8 vs 1%, P=0.009), although the PFS (P=0.43) and OS (P=0.88) did not significantly differ between these groups.
Fluoropyrimidine-based chemotherapy was modestly effective as a second-line chemotherapy for advanced BTC patients after failure of GEMCIS. Fluoropyrimidine-platinum combination therapy was not associated with improved survival outcomes, as compared with fluoropyrimidine monotherapy.
我们旨在评估在吉西他滨联合顺铂（GEMCIS）治疗失败后，二线氟嘧啶类化疗方案对晚期胆管癌（BTC）患者的疗效。
我们回顾性研究了2010年12月至2015年6月期间接受一线GEMCIS治疗且组织学确诊为晚期BTC的患者。在748例接受一线GEMCIS治疗的患者中，321例（43%）随后接受了基于氟嘧啶的二线全身化疗。
分别有255例和66例患者接受了氟嘧啶单药治疗和氟嘧啶-铂联合治疗。在可测量疾病的患者中，总缓解率（ORR）为3%，疾病控制率为47%。中位随访27.6个月（范围0.9 - 70.4个月）后，中位无进展生存期（PFS）和总生存期（OS）分别为1.9个月（95%置信区间（CI），1.6 - 2.2）和6.5个月（95% CI，5.9 - 7.0）。接受氟嘧啶-铂联合治疗的患者ORR显著高于接受氟嘧啶单药治疗的患者（8% vs 1%，P = 0.009），尽管两组之间的PFS（P = 0.43）和OS（P = 0.88）无显著差异。
对于GEMCIS治疗失败后的晚期BTC患者，基于氟嘧啶的化疗作为二线化疗有一定疗效。与氟嘧啶单药治疗相比，氟嘧啶-铂联合治疗未带来生存结局的改善。
