Japanese Journal of Clinical Oncology Advance Access published online on October 17, 2007
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hym116
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© 2007 Foundation for Promotion of Cancer Research
A Multi-center Retrospective Analysis of Survival Benefits of Chemotherapy for Unresectable Biliary Tract Cancer
1 Department of Biostatistics, Kyoto University School of Public Health, Kyoto
2 Division of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Chiba
3 Division of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo
4 Department of Gastroenterology, Aichi Cancer Center, Nagoya
5 Department of Gastroenterology, National Kyushu Cancer Center, Fukuoka
6 Division of Hepatobiliary and Pancreatic Medical Oncology, Kanagawa Cancer Center Hospital, Yokohama
7 Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka
8 Gastroenterological Center, Yokohama City University, Yokohama
9 Department of Imaging Diagnosis, Tochigi Cancer Center, Utsunomiya
10 Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
* For reprints and all correspondence: Naohiro Yonemoto, Department of Biostatistics, Kyoto University School of Public Health, Yoshida-konoe, Sakyou, Kyoto, Japan. E-mail: nyonemoto{at}pbh.med.kyoto-u.ac.jp
Received April 27, 2007; accepted July 28, 2007
Background: This study examined the effect of five systemic chemotherapy regimens on survival in patients with unresectable biliary tract cancer (BTC) as compared with the best supportive care (BSC).
Methods: This study retrospectively reviewed data from 413 consecutive patients with BTC who were seen at any of nine central hospitals in Japan between April 2000 and March 2003. Patients were eligible if they had intra- or extrahepatic cholangiocarcinoma or gallbladder cancer with no prior chemotherapy. Hazard ratios of treatment regimens were estimated using the Cox proportional hazard model and the propensity score method.
Results: Three-hundred and four patients were enrolled: 125 (41.1%) received BSC and 179 (58.9%) took chemotherapy. Of those who received chemotherapy, 58 (19.1%) took gemcitabine (GEM), 45 (14.5%) took a cisplatin (CDDP)-based regimen, 30 (9.9%) took a 5-fluorouracil (5-FU)-based regimen, 27 (8.9%) took 5-FU + doxorubicin + mitomycin (FAM) and 20 (6.6%) took S-1. The response rate was 8.4% (n = 15). The CDDP-based regimen was associated with a high frequency of toxicity symptoms. The adjusted hazard ratio for GEM in the Cox regression was 0.53 (95% CI 0.34–0.82) and the hazard ratio for the CDDP-based regimen was 0.49 (95% CI 0.36–0.99).
Conclusion: Chemotherapy with GEM may benefit patients with BTC.
Key Words: biliary tract cancer • chemotherapy • survival • retrospective study • clinical trial
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