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吉西他滨-顺铂(GC)作为可切除 II 期和 III 期胆囊癌(GBC)的辅助化疗:一种潜在的前进方向。

Gemcitabine-cisplatin (GC) as adjuvant chemotherapy in resected stage II and stage III gallbladder cancers (GBC): a potential way forward.

机构信息

Department of Medical Oncology, Tata Memorial Hospital, E. Borges Road, Parel, Mumbai, 400012, India.

Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, 400012, India.

出版信息

Med Oncol. 2018 Mar 21;35(4):57. doi: 10.1007/s12032-018-1115-6.

Abstract

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.

摘要

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。

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