Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India.
Department of Statistics, Advanced Centre for Treatment, Research and Education in Cancer, Mumbai, India.
J Hepatobiliary Pancreat Sci. 2017 May;24(5):262-267. doi: 10.1002/jhbp.439. Epub 2017 Apr 11.
Gemcitabine-cisplatin (GC) and gemcitabine-oxaliplatin (GO) are the most commonly used regimens in advanced gallbladder cancer (GBC).
The data of patients with advanced GBC, treated between January 2013 and June 2015 were retrieved. A 1:1 matching without replacement was performed by using nearest neighbor matching method.
A total of 326 patients (163 GC and 163 GO), were matched 1:1 by age and gender. The response rates for GC and GO were 31.2% and 36.3% (P = 0.350). The overall median event free survival (EFS) was 4.34 months (95% CI 4.030-4.644 months). The median EFS was 4.67 months (95% CI 4.060-5.271 months) in GC cohort and 3.88 months (95% CI 3.369-4.385 months) in GO cohort (P = 0.023). The overall median OS was 8.016 months (95% CI 7.361-8.672 months). The median OS was 8.02 months (95% CI 7.257-8.776 months) in GC cohort and 7.79 months (95% CI 6.690-8.88 months) in GO cohort (P = 0.455). The incidence of Grade 2/3 peripheral neuropathy (9.2% vs. 3.1%; P = 0.445) and Grade 3/4 transamintis (14.7% vs. 6.1%) was higher with GO while the incidence of anemia (22.1% vs. 6.7%; P < 0.001), neutropenia (7.3% vs. 2.4%; P = 0.49) and thrombocytopenia (9.8% vs. 3.7%; P = 0.033) was higher with GC.
Gemcitabine-cisplatin or gemcitabine-oxaliplatin can be used as an initial regimen in advanced GBC. Higher EFS, potentially lower costs, lower incidence of peripheral neuropathy and hepatotoxicity favor the use of GC, whereas a lower incidence of hematological toxicities, and potential ease of administration in patients with borderline renal and cardiac functions favor GO.
吉西他滨联合顺铂（GC）和吉西他滨联合奥沙利铂（GO）是晚期胆囊癌（GBC）最常用的治疗方案。
检索了 2013 年 1 月至 2015 年 6 月期间接受治疗的晚期 GBC 患者的数据。采用最近邻匹配法进行 1:1 无替换匹配。
共 326 名患者（GC 组 163 例，GO 组 163 例），按年龄和性别进行 1:1 匹配。GC 组和 GO 组的缓解率分别为 31.2%和 36.3%（P=0.350）。总体中位无事件生存期（EFS）为 4.34 个月（95%CI 4.030-4.644 个月）。GC 组的中位 EFS 为 4.67 个月（95%CI 4.060-5.271 个月），GO 组为 3.88 个月（95%CI 3.369-4.385 个月）（P=0.023）。总体中位总生存期（OS）为 8.016 个月（95%CI 7.361-8.672 个月）。GC 组的中位 OS 为 8.02 个月（95%CI 7.257-8.776 个月），GO 组为 7.79 个月（95%CI 6.690-8.88 个月）（P=0.455）。GO 组的 2/3 级周围神经病变（9.2% vs. 3.1%；P=0.445）和 3/4 级肝转氨酶升高（14.7% vs. 6.1%）发生率较高，而 GC 组的贫血（22.1% vs. 6.7%；P<0.001）、中性粒细胞减少（7.3% vs. 2.4%；P=0.49）和血小板减少症（9.8% vs. 3.7%；P=0.033）发生率较高。
吉西他滨联合顺铂或吉西他滨联合奥沙利铂可作为晚期 GBC 的初始治疗方案。较高的 EFS、潜在的较低成本、较低的周围神经病变和肝毒性发生率支持 GC 的使用，而较低的血液学毒性发生率以及边缘肾功能和心功能患者的潜在易于管理性则有利于 GO。
