Role of Combination Chemotherapy with 5-Fluorouracil, Cisplatin and Paclitaxel for Advanced Gall Bladder Cancer

Mumtaz Ahmad Ansari, Satyendra K. Tiwary, Uday Pratap Shahi, Vijay K. Shukla

Department of General Surgery and Radiotherapy, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.

DOI: 10.4236/jct.2014.53032                

Abstract

Aim: The prognosis for patients with advanced Gallbladder carcinoma is poor. Due to unresectability and relatively ineffective chemotherapy available, a need exists for effective chemotherapeutic regimen. The aim of this study was to determine the efficacy and safety profile of 5-fluorouracil, cisplatin and paclitaxel in patients with advanced Gallbladder cancer. Material and Methods: From January 2002 to July 2004, 40 patients of advanced carcinoma Gallbladder received 5-fluorouracil, cisplatin and paclitaxel. On day 1, paclitaxel was given (150 mg/m²), cisplatin was given on day 2 (50 mg/m²) and 5-fluorouracil was given from day 1 to day 3 (500 mg/m²). This cycle was repeated every three weeks and patient assessment was done. Results: Forty patients were enrolled in this study. Thirty-five were assessed for response. Five patients were lost in follow up. There were thirty females and ten males. A median of three cycles of treatment (range one to seven) was administered. Two patients achieved complete response and eleven had partial responses giving an overall response rate of 32.5% in the intention-to-treat population (95% confidence interval 11.1% to 46.5%). The median response duration was 5.3 months. The median time to progression and overall survival was 4.1 months and 11.2 months, respectively. The most common grade 3 adverse effects were neutropenia (30%), nausea (20%), vomiting (15%), diarrhea (10%), stomatitis (5%), and peripheral neuropathy (5%). Only one case had febrile neutropenia. There was no treatment related death. Conclusions: The combination of 5-fluorouracil, cisplatin and paclitaxel has promising anti-tumor activity and is well tolerated in patients with advanced and metastatic Gallbladder cancer.

Keywords

Advanced Gallbladder Carcinoma; Combination Chemotherapy; Prognosis

Conflicts of Interest

The authors declare no conflicts of interest.

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