Choi Sung Hoon, Kang Incheon, Lee Sung Hwan, Kang Beodeul, Cheon Jaekyung, Kim Dae Jung, Kim Gwangil, Kwon Chang-Il, Ko Kwang Hyun, Chon Hong Jae
Department of Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
Department of Medical Oncology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
Surgery. 2023 Feb;173(2):280-288. doi: 10.1016/j.surg.2022.09.028. Epub 2022 Nov 23.
This study was conducted to evaluate the clinical feasibility of nab-paclitaxel plus gemcitabine-cisplatin triplet chemotherapy in patients with locally advanced cholangiocarcinoma in real-world practice.
We retrospectively reviewed patients with locally advanced cholangiocarcinoma who were treated with nab-paclitaxel plus gemcitabine-cisplatin between October 2019 and August 2021 at a single institution. The initial diagnosis of cholangiocarcinoma was histologically confirmed.
One hundred twenty-nine patients were included in this study. Among the patients with a measurable lesion (57.4%), the objective response rate and disease control were 60.8% and 91.9%, respectively. Seventy-seven patients (59.7%) were determined as resectable after triplet chemotherapy, but 73 (56.6%) underwent subsequent curative surgery. The major postoperative complication rate was 15.1%, and there were 2 postoperative mortalities (2.7%). There were 6 complete remission cases (8.2%) in the final pathology. The R0 resection was achieved in 67 patients (91.8%). Despite the initial locally advanced cholangiocarcinoma, a pathologic T stage of less than T2 was reported in 67 patients (91.8%). Fifty-two patients (71.2%) had no lymph node metastasis. Patients who underwent surgery after triplet chemotherapy had significantly higher 12-month overall survival (95.9% vs 76.8%; P < .001) than those treated with chemotherapy alone.
Nab-paclitaxel plus gemcitabine-cisplatin chemotherapy demonstrated a down-staging effect through a high response rate, indicating that this triplet chemotherapy is feasible as induction therapy in patients with locally advanced cholangiocarcinoma.
本研究旨在评估在现实临床实践中，纳米白蛋白结合型紫杉醇联合吉西他滨 - 顺铂三联化疗用于局部晚期胆管癌患者的临床可行性。
我们回顾性分析了2019年10月至2021年8月在一家机构接受纳米白蛋白结合型紫杉醇联合吉西他滨 - 顺铂治疗的局部晚期胆管癌患者。胆管癌的初始诊断经组织学证实。
本研究共纳入129例患者。在有可测量病灶的患者中（57.4%），客观缓解率和疾病控制率分别为60.8%和91.9%。77例患者（59.7%）在三联化疗后被判定为可切除，但73例（56.6%）接受了后续的根治性手术。主要术后并发症发生率为15.1%，术后有2例死亡（2.7%）。最终病理有6例完全缓解病例（8.2%）。67例患者（91.8%）实现了R0切除。尽管初始为局部晚期胆管癌，但67例患者（91.8%）报告病理T分期小于T2。52例患者（71.2%）无淋巴结转移。三联化疗后接受手术的患者12个月总生存率显著高于单纯接受化疗的患者（95.9%对76.8%；P <.001）。
纳米白蛋白结合型紫杉醇联合吉西他滨 - 顺铂化疗通过高缓解率显示出降期效果，表明这种三联化疗作为局部晚期胆管癌患者的诱导治疗是可行的。
