RESUMO
BACKGROUND: Gemcitabine and oxaliplatin (GemOx) is a standard combination regimen in advanced biliary tract cancer (BTC). There is limited evidence on its efficacy and safety in real life. METHODS: A retrospective multicentre cohort study in the South East Region of Sweden, covering nine years (2011-2020) and three hospitals where GemOx was treatment of choice, was designed. Clinicopathological prognostic parameters were explored. RESULTS: One hundred and twenty-one patients with advanced BTC were identified. Median overall and progression-free survival (OS and PFS) were 8.9 (95% CI = 7.2-10.6) and 5.3 (95% CI = 3.8-6.7) months. Performance status according to Eastern Cooperative Oncology Group (PS according to ECOG) 1-2 and primary gallbladder carcinoma were independent predictors for poor OS. PS and derived neutrophil/lymphocyte ratio were predictive for PFS. The most common severe type of myelosuppresion was grade 3 neutropenia that was recorded in 8%. Fifty-three (43.8%) experienced at least one episode of unplanned hospitalisation. One hundred and seventeen (97%) received oxaliplatin with lower dosage than was utilized in previous phase III trials (80-85 vs. 100 mg/m2) and a majority received further dose reductions of oxaliplatin and/or gemcitabine. CONCLUSION: The outcome of GemOx in advanced BTC appears comparable in controlled trials and real-world contexts. A lower dose of oxaliplatin seems more tolerable without compromising the outcome.
