吉西他濱聯合鉑類化療一線治療肝膽管癌有效

吉西他濱聯合基於鉑類的化療用於肝膽管癌一線治療：AGEO法國多中心回顧性研究

摘 要

背景：肝膽管細胞癌（cHCC-ICC）是一種罕見的肝臟腫瘤，對其沒有化療敏感性數據。這項多中心研究的目的是評估吉西他濱加鉑作為一線治療cHCC-ICC的總生存期（OS）、無進展生存期（PFS）和預後因素。

Background：Hepatocholangiocarcinoma (cHCC-ICC) is a rare liver tumour for which no data on chemosensitivity exist.The aims of this multicentre study were to evaluate overall survival (OS), progression-free survival (PFS), and prognostic factors in cHCC-ICC treated by gemcitabine plus platinum as first-line.

方法：回顧性分析2008年至2017年吉西他濱聯合鉑類化療治療不能切除的cHCC-ICC。診斷基於組織學，或者ICC或HCC組織學，根據與不一致的血清腫瘤標誌物升高相關的不一致的計算機化的層析成像掃描增強模式提示替代腫瘤。採用Kaplan-Meier法評估OS和PFS，Log-rank檢驗和Cox模型評估預後因素。

Methods：Unresectable cHCC-ICC treated by gemcitabine plus platinum-based chemotherapy between 2008 and 2017 were retrospectively analysed.Diagnosis was based on histology or, in case of ICC or HCC histology, on discordant computerised tomography scan enhancement patterns associated with discordant serum tumour marker elevation suggesting the alternative tumour.OS and PFS were evaluated by Kaplan-Meier method and prognostic factors by Log-rank test and Cox model.

結果：在30例患者中，22例（73.3％）組織學證實了cHCC-ICC。 18例（60％）接受吉西他濱加奧沙利鉑（GEMOX），9例（30％）GEMOX加貝伐單抗，3例（10％）吉西他濱加順鉑。 在28例患者中報道RECIST標準：首次評估時8例（28.6％）顯示部分緩解，14例（50％）疾病穩定，6例（21.4％）腫瘤進展。中位PFS和OS分別為9.0和16.2個月。血清膽紅素≥30μmol/ L（P = 0.001）和HBV和/或HCV血清學陽性（P = 0.014）是OS預後不良的獨立因素。

Results：Among 30 patients included, cHCC-ICC was histologically proven in 22 (73.3%).18 (60%) received gemcitabine plus oxaliplatin (GEMOX), 9 (30%) GEMOX plus bevacizumab, and 3 (10%) gemcitabine plus cisplatin.RECIST criteria were reported in 28 patients: 8 (28.6%) showed partial response, 14 (50%) stable disease, and 6 (21.4%) tumour progression at first evaluation.Median PFS and OS were 9.0 and 16.2 months, respectively.Serum bilirubin ≥30 μmol l^- 1 (P=0.001) and positive serology for HBV and/or HCV (P=0.014) were independent poor prognostic factors for OS.

結論：吉西他濱加鉑類為基礎的化療作為晚期cHCC-ICC一線治療是有效的。

Conclusions：Gemcitabine plus platinum-based chemotherapy is effective as first-line for advanced cHCC-ICC.

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