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FOLFOX-4 regimen or single-agent gemcitabine as first-line chemotherapy in advanced biliary tract cancer.
- Source :
-
American journal of clinical oncology [Am J Clin Oncol] 2013 Oct; Vol. 36 (5), pp. 466-71. - Publication Year :
- 2013
-
Abstract
- Objectives: We conducted a retrospective cohort study to compare 2 different chemotherapy regimens for advanced biliary tract cancer (BTC).<br />Methods: Records of patients consecutively treated in our institution for advanced BTC from 2001 to 2006 were retrieved. Chemotherapy treatment with FOLFOX-4 regimen was routinely offered as first option; gemcitabine (GEM) as single agent was proposed as an alternative option to patients who refused central venous catheter implantation. Toxicity, overall response rate, progression-free survival (PFS), and overall survival (OS) obtained with the 2 treatments were evaluated.<br />Results: Twenty-two patients were treated with FOLFOX-4, whereas 18 patients received GEM. In the FOLFOX-4 group, the overall response rate was 13.6% (95% confidence interval [CI], 4.7-33.3), with 1 complete response and 2 partial responses, and 54.5% (95% CI, 34.7-73.1) of disease control rate (complete response+partial response+stable disease). Median OS was 14.1 months (95% CI, 9.1-18.8) and median PFS 5.44 months (95% CI, 3.2-6.3). In the GEM group, we observed no objective response, whereas 27.7% (95% CI, 12.5-50.9) obtained disease control. Median OS was 8.3 months (95% CI, 4.7-12.9) and median PFS 3.9 months (95% CI, 2.2-5.4). Toxicity, mainly hematological, was acceptable for both treatments. On a multivariable Cox model including a propensity score, only the performance status and chemotherapy regimen were confirmed as strong predictors of OS, with an hazard ratio of 0.49 (95% CI, 0.24-0.99) in favor of FOLFOX-4.<br />Conclusions: The combination chemotherapy with oxaliplatin and 5-fluorouracil is well tolerated and seems to provide prolonged survival than GEM alone in advanced BTC treatment, but further randomized trials are warranted.
- Subjects :
- Adolescent
Adult
Aged
Biliary Tract Neoplasms mortality
Biliary Tract Neoplasms pathology
Bone Neoplasms drug therapy
Bone Neoplasms mortality
Bone Neoplasms secondary
Deoxycytidine administration & dosage
Deoxycytidine analogs & derivatives
Female
Fluorouracil administration & dosage
Follow-Up Studies
Humans
Leucovorin administration & dosage
Liver Neoplasms drug therapy
Liver Neoplasms mortality
Liver Neoplasms secondary
Lung Neoplasms drug therapy
Lung Neoplasms mortality
Lung Neoplasms secondary
Male
Middle Aged
Neoplasm Recurrence, Local mortality
Neoplasm Recurrence, Local pathology
Neoplasm Staging
Organoplatinum Compounds administration & dosage
Oxaliplatin
Peritoneal Neoplasms drug therapy
Peritoneal Neoplasms mortality
Peritoneal Neoplasms secondary
Prognosis
Retrospective Studies
Survival Rate
Young Adult
Gemcitabine
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Biliary Tract Neoplasms drug therapy
Neoplasm Recurrence, Local drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1537-453X
- Volume :
- 36
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- American journal of clinical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 22781390
- Full Text :
- https://doi.org/10.1097/COC.0b013e31825691c3