TITLE:
Role of Combination Chemotherapy with 5-Fluorouracil, Cisplatin and Paclitaxel for Advanced Gall Bladder Cancer
AUTHORS:
Mumtaz Ahmad Ansari, Satyendra K. Tiwary, Uday Pratap Shahi, Vijay K. Shukla
KEYWORDS:
Advanced Gallbladder Carcinoma; Combination Chemotherapy; Prognosis
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.5 No.3,
March
19,
2014
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.