Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan.
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8654, Japan.
Curr Oncol. 2023 Jul 27;30(8):7229-7240. doi: 10.3390/curroncol30080524.
The safety and effectiveness of chemotherapy in elderly patients with biliary tract cancer (BTC) remain unclear. Therefore, we retrospectively reviewed patients who underwent chemotherapy for locally advanced, metastatic, or recurrent BTC at our institution from January 2016 to December 2021. Of the 283 included patients, 91 (32.5%) were aged 75 years or older when initiating chemotherapy. Elderly patients were more likely than non-elderly patients to receive monotherapy with gemcitabine or S-1 (58.7% vs. 9.4%, < 0.001) and were less likely to experience grade 3-4 toxicities (55.4% vs. 70.2%, = 0.015). The rates of termination due to intolerance (6.5% vs. 5.8%, = 0.800) and transition to second-line chemotherapy (39.1% vs. 40.3%, = 0.849) were similar between groups. In the overall cohort, age was not an independent predictor of overall survival (OS). Within the elderly cohort, there were no differences in severe adverse events between patients receiving monotherapy and combination therapy (50.0% vs. 63.2%, = 0.211). Median OS was longer in the combination therapy group (10.4 vs. 14.1 months; = 0.010); however, choice of monotherapy was not an independent predictor of overall survival. Monotherapy appears to be a viable alternative in selected elderly BTC patients.
在老年胆道癌（BTC）患者中，化疗的安全性和有效性仍不清楚。因此，我们回顾性分析了 2016 年 1 月至 2021 年 12 月在我院接受局部晚期、转移性或复发性 BTC 化疗的患者。在纳入的 283 例患者中，91 例（32.5%）在开始化疗时年龄为 75 岁或以上。与非老年患者相比，老年患者更倾向于接受吉西他滨或 S-1 的单药治疗（58.7% vs. 9.4%，<0.001），且发生 3-4 级毒性的可能性更低（55.4% vs. 70.2%，=0.015）。因不耐受而终止治疗的比例（6.5% vs. 5.8%，=0.800）和转为二线化疗的比例（39.1% vs. 40.3%，=0.849）在两组之间相似。在整个队列中，年龄不是总生存期（OS）的独立预测因素。在老年队列中，接受单药和联合治疗的患者严重不良事件之间没有差异（50.0% vs. 63.2%，=0.211）。联合治疗组的中位 OS 更长（10.4 个月 vs. 14.1 个月；=0.010）；然而，单药治疗选择不是总生存期的独立预测因素。单药治疗似乎是选择老年 BTC 患者的一种可行替代方案。
