{"title":"化疗对无法切除的非转移性胆管癌的治疗反应和生存率","authors":"Ajay Gupta, Puja Sahai, Manya Prasad, Hanuman Prasad Yadav, Gagan Srivastava, Nuneno Nakhro, Guresh Kumar, Namita Sharma","doi":"10.5005/jp-journals-10018-1396","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objectives: </strong>Limited studies have dwelt upon the treatment of unresectable, nonmetastatic cholangiocarcinoma as a separate entity. Hence, the management protocols are not clearly defined for this subgroup of patients. We aimed to analyze patients treated for unresectable, nonmetastatic cholangiocarcinoma.</p><p><strong>Materials and methods: </strong>We analyzed the treatment of patients with unresectable, nonmetastatic cholangiocarcinoma retrospectively.</p><p><strong>Results: </strong>A total of 162 cases of cholangiocarcinoma were reported to our center from 2016 to 2019, out of which 54 were unresectable and nonmetastatic. Thirty patients opted for treatment and were the subjects of this study. Of 30 patients, 24 had hyperbilirubinemia, out of which 10 received chemotherapy after biliary drainage procedure. Out of 30 patients, a total of 16 patients had received chemotherapy, while 14 did not. Gemcitabine/Cisplatin was the first-line chemotherapy administered to 9 patients, whereas 5 received Gemcitabine/Capecitabine and 2 received single-agent gemcitabine. Partial response was documented in 6 patients, and 4 patients had stable disease. The median overall survival was 12.04 months in patients who had received chemotherapy and 6.02 months in those who did not receive chemotherapy (<i>p</i> = 0.005). The median progression-free survival was 6.53 months for patients who had received chemotherapy. The aHR for mortality with chemotherapy compared with no chemotherapy was 0.353 (95% CI: 0.154-0.807).</p><p><strong>Conclusion: </strong>The study data demonstrate that gemcitabine combined with cisplatin- or capecitabine-based chemotherapy prolongs survival in patients with unresectable and nonmetastatic cholangiocarcinoma. In patients with cholangiocarcinoma associated with jaundice, biliary drainage procedure enables giving chemotherapy. Hyperbilirubinemia persisting despite drainage procedures portends poor prognosis and represents an unmet need.</p><p><strong>How to cite this article: </strong>Gupta A, Sahai P, Prasad M, et al. Treatment Response and Survival with Chemotherapy for Unresectable, Nonmetastatic Cholangiocarcinoma. Euroasian J Hepato-Gastroenterol 2024;14(1):5-8.</p>","PeriodicalId":516317,"journal":{"name":"Euroasian journal of hepato-gastroenterology","volume":"14 1","pages":"5-8"},"PeriodicalIF":0.0000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249901/pdf/","citationCount":"0","resultStr":"{\"title\":\"Treatment Response and Survival with Chemotherapy for Unresectable, Nonmetastatic Cholangiocarcinoma.\",\"authors\":\"Ajay Gupta, Puja Sahai, Manya Prasad, Hanuman Prasad Yadav, Gagan Srivastava, Nuneno Nakhro, Guresh Kumar, Namita Sharma\",\"doi\":\"10.5005/jp-journals-10018-1396\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and objectives: </strong>Limited studies have dwelt upon the treatment of unresectable, nonmetastatic cholangiocarcinoma as a separate entity. Hence, the management protocols are not clearly defined for this subgroup of patients. We aimed to analyze patients treated for unresectable, nonmetastatic cholangiocarcinoma.</p><p><strong>Materials and methods: </strong>We analyzed the treatment of patients with unresectable, nonmetastatic cholangiocarcinoma retrospectively.</p><p><strong>Results: </strong>A total of 162 cases of cholangiocarcinoma were reported to our center from 2016 to 2019, out of which 54 were unresectable and nonmetastatic. Thirty patients opted for treatment and were the subjects of this study. Of 30 patients, 24 had hyperbilirubinemia, out of which 10 received chemotherapy after biliary drainage procedure. Out of 30 patients, a total of 16 patients had received chemotherapy, while 14 did not. Gemcitabine/Cisplatin was the first-line chemotherapy administered to 9 patients, whereas 5 received Gemcitabine/Capecitabine and 2 received single-agent gemcitabine. Partial response was documented in 6 patients, and 4 patients had stable disease. The median overall survival was 12.04 months in patients who had received chemotherapy and 6.02 months in those who did not receive chemotherapy (<i>p</i> = 0.005). The median progression-free survival was 6.53 months for patients who had received chemotherapy. The aHR for mortality with chemotherapy compared with no chemotherapy was 0.353 (95% CI: 0.154-0.807).</p><p><strong>Conclusion: </strong>The study data demonstrate that gemcitabine combined with cisplatin- or capecitabine-based chemotherapy prolongs survival in patients with unresectable and nonmetastatic cholangiocarcinoma. In patients with cholangiocarcinoma associated with jaundice, biliary drainage procedure enables giving chemotherapy. Hyperbilirubinemia persisting despite drainage procedures portends poor prognosis and represents an unmet need.</p><p><strong>How to cite this article: </strong>Gupta A, Sahai P, Prasad M, et al. Treatment Response and Survival with Chemotherapy for Unresectable, Nonmetastatic Cholangiocarcinoma. 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引用次数: 0
摘要
背景和目的:将不可切除的非转移性胆管癌作为一个单独的实体进行治疗的研究非常有限。因此,对这一亚组患者的治疗方案没有明确定义。我们旨在分析不可切除、非转移性胆管癌患者的治疗情况:我们对不可切除、非转移性胆管癌患者的治疗进行了回顾性分析:2016年至2019年,我中心共接诊162例胆管癌患者,其中54例为不可切除、非转移性胆管癌。30名患者选择接受治疗,成为本研究的对象。30 名患者中,有 24 人出现高胆红素血症,其中 10 人在胆道引流术后接受了化疗。在 30 名患者中,共有 16 人接受过化疗,14 人未接受化疗。9名患者接受了吉西他滨/顺铂一线化疗,5名患者接受了吉西他滨/卡培他滨化疗,2名患者接受了单药吉西他滨化疗。6名患者出现部分反应,4名患者病情稳定。接受化疗患者的中位总生存期为12.04个月,未接受化疗患者的中位总生存期为6.02个月(P = 0.005)。接受化疗患者的中位无进展生存期为 6.53 个月。与未接受化疗的患者相比,接受化疗患者的死亡率aHR为0.353(95% CI:0.154-0.807):研究数据表明,吉西他滨联合顺铂或卡培他滨化疗可延长不可切除和非转移性胆管癌患者的生存期。对于伴有黄疸的胆管癌患者,可通过胆道引流术进行化疗。尽管进行了引流手术,但高胆红素血症仍持续存在,预示着预后不佳,这是一项尚未满足的需求:Gupta A, Sahai P, Prasad M, et al. 不可切除的非转移性胆管癌化疗的治疗反应和生存率。Euroasian J Hepato-Gastroenterol 2024;14(1):5-8.
Treatment Response and Survival with Chemotherapy for Unresectable, Nonmetastatic Cholangiocarcinoma.
Background and objectives: Limited studies have dwelt upon the treatment of unresectable, nonmetastatic cholangiocarcinoma as a separate entity. Hence, the management protocols are not clearly defined for this subgroup of patients. We aimed to analyze patients treated for unresectable, nonmetastatic cholangiocarcinoma.
Materials and methods: We analyzed the treatment of patients with unresectable, nonmetastatic cholangiocarcinoma retrospectively.
Results: A total of 162 cases of cholangiocarcinoma were reported to our center from 2016 to 2019, out of which 54 were unresectable and nonmetastatic. Thirty patients opted for treatment and were the subjects of this study. Of 30 patients, 24 had hyperbilirubinemia, out of which 10 received chemotherapy after biliary drainage procedure. Out of 30 patients, a total of 16 patients had received chemotherapy, while 14 did not. Gemcitabine/Cisplatin was the first-line chemotherapy administered to 9 patients, whereas 5 received Gemcitabine/Capecitabine and 2 received single-agent gemcitabine. Partial response was documented in 6 patients, and 4 patients had stable disease. The median overall survival was 12.04 months in patients who had received chemotherapy and 6.02 months in those who did not receive chemotherapy (p = 0.005). The median progression-free survival was 6.53 months for patients who had received chemotherapy. The aHR for mortality with chemotherapy compared with no chemotherapy was 0.353 (95% CI: 0.154-0.807).
Conclusion: The study data demonstrate that gemcitabine combined with cisplatin- or capecitabine-based chemotherapy prolongs survival in patients with unresectable and nonmetastatic cholangiocarcinoma. In patients with cholangiocarcinoma associated with jaundice, biliary drainage procedure enables giving chemotherapy. Hyperbilirubinemia persisting despite drainage procedures portends poor prognosis and represents an unmet need.
How to cite this article: Gupta A, Sahai P, Prasad M, et al. Treatment Response and Survival with Chemotherapy for Unresectable, Nonmetastatic Cholangiocarcinoma. Euroasian J Hepato-Gastroenterol 2024;14(1):5-8.