ABSTRACT
OBJECTIVE: The aim of this study was to investigate the outcomes of gemcitabine-treated patients with inoperable biliary tract cancers. METHODS: We conducted a retrospective study of consecutively treated 22 inoperable biliary tract cancer patients with gemcitabine (500-1,000 mg/m(2) on days 1, 8, 15 every 4 weeks) as first-line, and 17 patients as second- or third-line treatment. RESULTS: The response rate of patients treated with gemcitabine as first-line and second- or third-line treatment was 5.3 and 28.5%, respectively. The median overall survival time in the first-, and second- or third-line treatment groups was 8.3 and 17.0 months, and the 1-year survival rate was 44.0 and 50.9%, respectively. The present study also suggests the possibility that the prognosis of patients with high levels of C-reactive protein and total bilirubin, or a low level of albumin might be worse. CONCLUSIONS: Our results indicate that the treatment of inoperable biliary tract cancers with gemcitabine is feasible. There was no difference in the response rate and overall survival between biliary tract cancer patients in the first- and second- or third-line treatment groups. We also present the systematic review of literature of the recent treatment results of biliary tract cancers treated with gemcitabine.
Subject(s)
Antimetabolites, Antineoplastic/therapeutic use , Biliary Tract Neoplasms/drug therapy , Deoxycytidine/analogs & derivatives , Adult , Aged , Analysis of Variance , Biliary Tract Neoplasms/pathology , Deoxycytidine/therapeutic use , Female , Humans , Male , Middle Aged , Proportional Hazards Models , Retrospective Studies , Survival Analysis , Treatment Outcome , GemcitabineABSTRACT
Pregnancy complicated with myelodysplastic syndrome (MDS) is rare and case management is controversial. We report six cases of MDS that were successfully managed during pregnancy including uneventful transvaginal delivery and satisfactory postpartum clinical prognosis. Two patients with MDS who became pregnant twice had normal uneventful deliveries showing no deterioration of MDS. Our findings suggest that pregnancy should be allowed to full-term in MDS patients, especially those of the refractory anemia type, but strict management should be provided before, during and after pregnancy. Pancytopenia might develop during pregnancy but the likelihood of transformation of MDS to leukemia due to pregnancy is remote.
