Curative effect analysis of 3DCRT combined with thalidomide and GEMOX regimen in advanced intrahepatic cholangiocarcinoma

Abstract

Objective To investigate the efficacy and adverse reaction of three-dimensional conformal radiotherapy (3DCRT) combined with thalidomide and GEMOX regimen (gemcitabine + oxaliplatin) in patients with advanced intrahepatic cholangiocarcinoma. Methods A total of 100 patients with advanced intrahepatic cholangiocarcinoma in 901 Hospital of Joint Logistics Support Force of Chinese People′s Liberation Army from March 2015 to June 2018 were divided into chemotherapy group (n=50) and combination group (n=50) by random number table method. The chemotherapy group was treated with thalidomide and GEMOX regimen, and the combined group was treated with 3DCRT on the basis of the chemotherapy regimen. The levels of serum tumor markers, clinical efficacy and adverse reactions of patients in the two groups were compared before and after treatment. Results The levels of serum carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125) and carbohydrate antigen 19-9 (CA19-9) in the combined group were (8.76±2.69) μg/L, (76.17±10.12)×103 U/L and (169.85±78.97)×103 U/L respectively, which were significantly lower than those of (12.46±3.47) μg/L, (104.56±14.38)×103 U/L, (312.45±71.36)×103 U/L in the chemotherapy group, with statistically significant differences (t=5.959, P<0.001; t=11.416, P<0.001; t=9.474, P<0.001). The clinical benefit rate and the total effective rate of the combined group were respectively 64.0% (32/50) and 88.0% (44/50), which were higher than those of 42.0% (21/50) and 72.0% (36/50) in the chemotherapy group, with statistically significant differences (χ2=4.857, P=0.028; χ2=4.000, P=0.046). The incidences of leukopenia, nausea and vomiting, constipation and alopecia of patients in the combined group were 20.0% (10/50), 24.0% (12/50), 30.0% (15/50) and 12.0% (6/50) respectively, which were 14.0% (7/50), 16.0% (8/50), 24.0% (12/50) and 8.0% (4/50) respectively in the chemotherapy group, with no statistically significant differences (χ2=0.638, P=0.424; χ2=1.000, P=0.317; χ2=0.457, P=0.499; χ2=0.444, P=0.505). Conclusion 3DCRT combined with thalidomide and GEMOX regimen can significantly reduce the levels of serum tumor markers in patients with advanced intrahepatic cholangiocarcinoma, enhance the short-term efficacy without significantly increasing and aggravating adverse reactions. Key words: Bile duct neoplasms; Antineoplastic combined chemotherapy protocols; Three-dimensional conformal radiotherapy technology; Thalidomide