Abstract
Background: Currently, there is no standard therapy for advanced gallbladder cancer. In patients who are beyond the scope of curative treatment at the time of diagnosis, palliative chemotherapy and palliative radiotherapy can be prescribed but the survival is counted in months and the quality of life is further hampered due to toxicity of drugs.
Objective: With respect to response and acute toxicities we evaluated the efficacy and toxicities of radiotherapy and chemotherapy in three arms. We compared the loco regional response in 3 arms after completion of treatment and at the end of 2 months and 6 months of radiotherapy and chemotherapy.
Material and Methods: Sixty patients of surgically unresectable locally advanced carcinoma gall bladder were enrolled. They were randomized in three arms. Arm A received radiotherapy 30 Gy in 10 fractions, Arm B received radiotherapy 20 Gy in 5 fractions and Arm C received chemotherapy Inj gemcitabine with Inj cisplatin for 6 cycles.
Results: Median follow up of all arms were 8 months. 8 months progression free survival (22% vs 10.5% vs 29.4% p value-0.2010) and overall survival (54% vs 42% vs 51% p value-0.08) were comparable in 3 arms. Hematological toxicities, nausea and vomiting were significantly greater in chemotherapy arm. Locoregional response and QOL were comparable in all 3 arms.
Conclusion: Palliative radiotherapy had comparable locoregional response with significantly lower toxicity profile. Thus, palliative radiotherapy can be considered as an alternative to chemotherapy in treatment of locally advanced carcinoma gall bladder.
Keyword: Gall bladder cancer, palliative chemotherapy, palliative radiotherapy, Inj gemcitabine, Inj cisplatin, locoregional response.
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Corresponding Author
Avinash Ranjan
Junior Resident IIIrd Year, Department of Radiation Oncology J.K. Cancer Institute, Kanpur, Uttar Pradesh, India
DOI: https://dx.doi.org/10.18535/jmscr/v10i2.28
