Cancer Management and Research (Jan 2021)

Efficacy Analysis of Adjuvant Chemotherapy with Gemcitabine Plus Platinum or S-1 in Biliary Tract Carcinoma: A Multi-Center Retrospective Study

  • Gao H,
  • Tian T,
  • Li S,
  • Zhang Y,
  • Fu X,
  • Zheng X,
  • Liu N,
  • Jiang A,
  • Ren M,
  • Zhang X,
  • Liang X,
  • Ruan Z,
  • Geng Z,
  • Yao Y

Journal volume & issue
Vol. Volume 13
pp. 889 – 898

Abstract

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Huan Gao,1 Tao Tian,1 Suoni Li,2 Yinbin Zhang,3 Xiao Fu,1 Xiaoqiang Zheng,1 Na Liu,1 Aimin Jiang,1 Mengdi Ren,1 Xiaoni Zhang,1 Xuan Liang,1 Zhiping Ruan,1 Zhimin Geng,4,* Yu Yao1,* 1Department of Medical Oncology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China; 2Department of Medical Oncology, Tumor Hospital of Shaanxi, Xi’an, People’s Republic of China; 3Department of Oncology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China; 4Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yu YaoDepartment of Medical Oncology, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277 Yanta West Road, Xi’an, Shaanxi 710061, People’s Republic of ChinaTel/Fax +86-29-85323422Email [email protected] GengDepartment of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277 Yanta West Road, Xi’an, Shaanxi 710061, People’s Republic of ChinaTel/Fax +86-29-85323893Email [email protected]: Biliary tract cancers (BTCs) have a poor overall prognosis, as patients who underwent curative surgery frequently experience disease recurrence. At present, there is a paucity of well-documented adjuvant chemotherapy regimen. This study aimed to assess whether gemcitabine plus platinum or S-1 adjuvant chemotherapy have different impact on relapse-free survival (RFS).Patients and Methods: We selected patients undergoing radical biliary tract cancer surgery, pathologically confirmed adenocarcinoma and received gemcitabine plus platinum (cisplatin or oxaliplatin) or S-1 adjuvant chemotherapy from September 2013 to May 2020. The primary study endpoint was RFS. The secondary endpoint was safety.Results: Overall 136 patients were enrolled. The median follow-up was 32.3 months and the median RFS was 17.0 months (95% CI 8.9– 25.1). The median RFS was 14.1 months (95% CI 6.7– 21.5) in gemcitabine plus platinum group and 33.0 months (95% CI 9.3– 56.7) in gemcitabine plus S-1 (GS) group, a non-significant difference both in univariate (P=0.092) and in multivariate analysis (P=0.058). Lymph node status (N- vs N+: HR=0.477, 95% CI 0.285– 0.799; P=0.005) and chemotherapy cycles (< 6 vs 6– 8: HR=1.828, 95% CI 1.117– 2.993; P=0.016) were independent impact factors for RFS. GS group had lower incidence of adverse reactions.Conclusion: Compared with gemcitabine plus platinum, GS regimen has a tendency to obtain longer RFS (although there is no statistically significant difference) and less toxic. GS regimen has the potential to be investigated as a standard regimen for adjuvant chemotherapy.Keywords: biliary tract cancer, adjuvant chemotherapy, gemcitabine, platinum, S-1

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