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一线吉西他滨和顺铂治疗后进展期胆管癌患者的多学科治疗：单中心经验

Multidisciplinary Treatment of Patients with Progressive Biliary Tract Cancer after First-Line Gemcitabine and Cisplatin: A Single-Center Experience.

作者信息

Müller Christian, Omari Jazan, Mohnike Konrad, Bär Caroline, Pech Maciej, Keitel Verena, Venerito Marino

机构信息

Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Hospital, 39120 Magdeburg, Germany.

Department of Radiology and Nuclear Medicine, Otto-von-Guericke University Hospital, 39120 Magdeburg, Germany.

出版信息

Cancers (Basel). 2023 May 3;15(9):2598. doi: 10.3390/cancers15092598.

DOI:10.3390/cancers15092598
PMID:37174064
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10177261/
Abstract

BACKGROUND

Patients with unresectable biliary tract cancer (uBTC) who progress despite first-line gemcitabine plus cisplatin (GC) treatment have limited systemic options with a modest survival benefit. Data are lacking on the clinical effectiveness and safety of personalized treatment based on multidisciplinary discussion for patients with progressing uBTC.

METHODS

This retrospective single-center study included patients with progressive uBTC who received either best supportive care or personalized treatment based on multidisciplinary discussion, including minimally invasive, image-guided procedures (MIT); FOLFIRI; or both (MIT and FOLFIRI), between 2011 and 2021.

RESULTS

Ninety-seven patients with progressive uBTC were identified. Patients received best supportive care ( = 50, 52%), MIT ( = 14, 14%), FOLFIRI ( = 19, 20%), or both ( = 14, 14%). Survival after disease progression was better in patients who received MIT (8.8 months; 95% CI: 2.60-15.08), FOLFIRI (6 months; 95% CI: 3.30-8.72), or both (15.1 months; 95% CI: 3.66-26.50) than in patients receiving BSC (0.36 months; 95% CI: 0.00-1.24, < 0.001). The most common (>10%) grade 3-5 adverse events were anemia (25%) and thrombocytopenia (11%).

CONCLUSION

Multidisciplinary discussion is critical for identifying patients with progressive uBTC who might benefit the most from MIT, FOLFIRI, or both. The safety profile was consistent with previous reports.

摘要

背景

一线吉西他滨联合顺铂（GC）治疗后病情进展的不可切除胆管癌（uBTC）患者，其全身治疗选择有限，生存获益不大。目前缺乏关于进展期uBTC患者基于多学科讨论的个性化治疗的临床有效性和安全性的数据。

方法

这项回顾性单中心研究纳入了2011年至2021年间病情进展的uBTC患者，这些患者接受了最佳支持治疗或基于多学科讨论的个性化治疗，包括微创影像引导手术（MIT）、FOLFIRI方案，或两者联合（MIT和FOLFIRI）。

结果

共确定了97例病情进展的uBTC患者。患者接受了最佳支持治疗（n = 50，52%）、MIT（n = 14，14%）、FOLFIRI（n = 19，20%）或两者联合（n = 14，14%）。疾病进展后，接受MIT（8.8个月；95%CI：2.60 - 15.08）、FOLFIRI（6个月；95%CI：3.30 - 8.72）或两者联合（15.1个月；95%CI：3.66 - 26.50）的患者的生存期优于接受最佳支持治疗的患者（0.36个月；95%CI：0.oo - 1.24，P < 0.001）。最常见的（>10%）3 - 5级不良事件是贫血（25%）和血小板减少症（11%）。

结论

多学科讨论对于确定进展期uBTC患者中可能从MIT、FOLFIRI或两者联合中获益最大的患者至关重要。安全性与既往报告一致。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e80/10177261/a450e0650af4/cancers-15-02598-g003a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e80/10177261/bc453fe2b849/cancers-15-02598-g001a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e80/10177261/ccea03431877/cancers-15-02598-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e80/10177261/a450e0650af4/cancers-15-02598-g003a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e80/10177261/bc453fe2b849/cancers-15-02598-g001a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e80/10177261/ccea03431877/cancers-15-02598-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e80/10177261/a450e0650af4/cancers-15-02598-g003a.jpg

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