Efficacy Analysis of Adjuvant Chemotherapy with Gemcitabine Plus Platinum or S-1 in Biliary Tract Carcinoma: A Multi-Center Retrospective Study
Received 4 November 2020
Accepted for publication 7 January 2021
Published 29 January 2021 Volume 2021:13 Pages 889—898
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 4
Editor who approved publication: Dr Sanjeev Srivastava
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 work
Correspondence: Yu Yao
Department 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 China
Department 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 China
Purpose: 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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