Concurrent Chemoradiotherapy in Curatively Resected Gallbladder Carcinoma: A Propensity Score-Matched Analysis

Autor: Benxing Gu, Xiaonan Sun, Jingjing Shan, Qi Wang, Jian-Bin Hu, Hai Liu, Hong Yu, Xiujun Cai, Qichu Yang, Xiao Liang, Liwen Qian, Liming Shi
Rok vydání: 2017
Předmět:
Adult
Male
Cancer Research
medicine.medical_specialty
Time Factors
medicine.medical_treatment
Matched-Pair Analysis
Kaplan-Meier Estimate
Gastroenterology
Disease-Free Survival
03 medical and health sciences
0302 clinical medicine
Interquartile range
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
medicine
Carcinoma
Humans
Radiology
Nuclear Medicine and imaging

Stage (cooking)
Propensity Score
Aged
Retrospective Studies
Aged
80 and over

Radiation
business.industry
Gallbladder
Retrospective cohort study
Chemoradiotherapy
Middle Aged
medicine.disease
Surgery
Radiation therapy
medicine.anatomical_structure
Oncology
030220 oncology & carcinogenesis
Propensity score matching
Cohort
Multivariate Analysis
Feasibility Studies
Lymph Node Excision
Regression Analysis
030211 gastroenterology & hepatology
Female
Gallbladder Neoplasms
business
Zdroj: International journal of radiation oncology, biology, physics. 100(1)
ISSN: 1879-355X
Popis: Purpose To compare overall survival (OS) between patients receiving radical resection followed by concurrent chemoradiotherapy (S+CCRT) and patients receiving radical resection only (S) for advanced resectable gallbladder carcinoma (GBC). Methods and Materials Ninety-four GBC patients with stage pT2-4, N0-1, and M0 consented to inclusion in a clinical database from June 2003 to July 2013. Patients who received S+CCRT were matched by propensity score with those who received S through nearest-neighbor matching, with a caliper width of 0.2 to ensure similar baseline characteristics between each group. The effects of CCRT on OS and disease-free survival (DFS) were evaluated with Kaplan-Meier analysis. Cox proportional hazards regression was performed on the entire cohort. Adverse effects and oncologic outcomes were assessed. Results Seventy-eight patients with GBC (39 S+CCRT; 39 S) were matched according to propensity score; the 1-year, 3-year, and 5-year OS was 74.4%, 56.4%, and 42.4% for the S+CCRT group and 51.3%, 30.8%, and 17.9% for the S group. The median survival time was 27 months (interquartile range [IQR], 12-58 months) for the S+CCRT group versus 13 months (IQR, 5-30 months) for the S group ( P =.004), with the 1-year and 3-year DFS being 59.0% versus 35.9% and 48.7% versus 13.5%, respectively, and the median DFS being 23 months (IQR, 8-57 months) versus 7 months (IQR, 4-23 months) ( P =.004). Conclusions The OS of matched patients with stage II-IVA GBC is significantly improved by CCRT. Radiation therapy combined with single-agent or dual-agent chemotherapy was feasible and well tolerated.
Databáze: OpenAIRE
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