Department of Medical Oncology, Tata Memorial Hospital, E. Borges Road, Parel, Mumbai, 400012, India.
Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, 400012, India.
Med Oncol. 2018 Mar 21;35(4):57. doi: 10.1007/s12032-018-1115-6.
Data on adjuvant chemotherapy with gemcitabine-cisplatin (GC) in resected gallbladder cancers (GBC) are scarce. Patients who underwent upfront curative resection for GBC from 2010 to 2016 were analyzed. Patients with stage II-III GBC treated with adjuvant GC were analyzed. A total of 242 patients were evaluated, of whom 125 patients received GC regimen as adjuvant chemotherapy. The median age was 50 years (range 31-74), majority were female (77.6%), and 37 patients (29.6%) had raised CA 19.9 levels at baseline. One hundred and thirteen patients (90.4%) underwent radical cholecystectomy with R0 resections. Median number of GC administered was 6, with completion rates of 84%. Toxicity data were comprehensively available for 110 patients, with common grade 3 and grade 4 being neutropenia (9.9%), fatigue (7.3%) and febrile neutropenia (3.6%), respectively. With a median follow-up of 36.88 months, 3-year RFS was 60.3%. Patients with stage II (28%; n = 35), stage IIIA (28%; n = 35) and stage IIIB GBC (44%; n = 55) had a 3-year OS of 91.9, 67 and 58.1% (p = 0.001), respectively. Patients with stage II-III GBC undergoing R0 resections receiving adjuvant GC have good tolerance, high completion rates and encouraging outcomes in a non-trial high GBC prevalence scenario.
在接受根治性切除术的胆囊癌（GBC）患者中，吉西他滨联合顺铂（GC）辅助化疗的数据很少。分析了 2010 年至 2016 年接受 GBC 根治性切除术的患者。分析了接受辅助 GC 治疗的 II-III 期 GBC 患者。共评估了 242 例患者，其中 125 例患者接受了 GC 方案作为辅助化疗。中位年龄为 50 岁（范围 31-74），大多数为女性（77.6%），37 例（29.6%）基线时 CA19.9 水平升高。113 例（90.4%）患者行根治性胆囊切除术，R0 切除。GC 中位给药 6 个周期，完成率为 84%。110 例患者毒性数据全面，常见的 3 级和 4 级毒性分别为中性粒细胞减少症（9.9%）、乏力（7.3%）和发热性中性粒细胞减少症（3.6%）。中位随访 36.88 个月，3 年 RFS 为 60.3%。II 期（28%；n=35）、IIIA 期（28%；n=35）和 IIIB 期 GBC（44%；n=55）患者的 3 年 OS 分别为 91.9%、67%和 58.1%（p=0.001）。在非试验性高 GBC 发生率的情况下，接受 R0 切除术并接受辅助 GC 治疗的 II-III 期 GBC 患者耐受性良好，完成率高，预后良好。
