Best supportive care compared with chemotherapy and radiotherapy for unresectable gallbladder cancer: A tertiary care institute experience

Abstract

Context: Gallbladder represent the most common cancer among biliary tree, complete surgery offers only chance of cure, but most of patients with unresectable or metastatic stage, in such patients only palliative treatment be given. Aims: The aim of this retrospective study is to evaluate efficacy of chemotherapy with gemcitabine and oxaliplatin (GEMOX), and or with radiotherapy over best supportive care (BSC)) in unresectable gallbladder cancer (GBC). Materials and Methods: Patients with unresectable GBC were evaluated from our center between 2008 and 2011. Three cohorts were identified. Group A, BSC, Group B chemotherapy with GEMOX two weekly for maximum of six cycles. Group C, Chemotherapy with GEMOX and Radiotherapy. Patients underwent percutaneous transhepatic biliary drainage (PTBD) or Endoscopic retrograde cholangiopancreatography (ERCP) when required. Results: Total 50 patients included in analysis. 19 are male and 31 are female. 14 patients in Group A. 18 patients in Group B and 18 in Group C. Median follow up was 8.8 month. The progression free survival (PFS) of patients who received of BSC at 15 month was 18%. PFS of patients who received chemotherapy (CCT) at 28 month was 30%. PFS of patients who received CCT Chemotherapy and radiotherapy PFS at 15 month was 38%. When compared all three group none is statically significant ( P = 0.538). Conclusion: Judicious used of BSC along with chemotherapy and or with radiotherapy may help in increase in period of stable disease along with overall survival (OS) in selected group. In our retrospective analysis CCT with GEMOX and with radiotherapy has helped in improving the OS and PFS in few patients who had good performance status.