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Year : 2020  |  Volume : 9  |  Issue : 3  |  Page : 63-68

Is combination chemotherapy of cisplatin and gemcitabine in the first-line treatment of advanced gallbladder cancer the right choice? A study in indian patients from the gangetic belt

1 Department of Medicine and Oncology, Command Hospital Air Force, Bengaluru, Karnataka, India
2 Department of Medicine and Oncology, Command Hospital Airforce, Bengaluru, Karnataka, India
3 Department of Surgical Oncology, Command Hospital, Bengaluru, Karnataka, India

Correspondence Address:
Rahul Sud
Department of Medicine and Oncology, Command Hospital AirForce, Bengaluru - 560 007, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ccij.ccij_11_20

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Background: Owing to presentation at advanced stage, most of the time, gallbladder carcinoma is nonresectable. Nonsurgical palliative procedures such as stenting help in a limited number of patients. Although anecdotal Western data are present, combination chemotherapy data from Indian scenario are scanty. The present study was carried out with an aim to evaluate the response to first-line chemotherapy with cisplatin and gemcitabine in Indian patients with advanced gallbladder carcinoma. This observational study was conducted in the Departments of Oncology at the Army Command Hospital (Central Command), Lucknow, between April 2013 and May 2016. All patients presenting to this center with histologically proven advanced carcinoma of gallbladder were screened for eligibility for inclusion in the study. Patients and Methods: No prior approach for sample size calculation was followed owing to rarity of disease. Hence, all the patients falling in the sampling frame were included in the study. Power analysis was done post hoc. A total of 60 patients falling in sampling frame and completing 6 months of treatment protocol were enrolled in the study. Statistical Analysis Used: Chi-square test and independent samples t-test were used to compare and evaluate the data. P < 0.05 indicated a statistically significant association. Results: At 3 months, majority of the patients (28; 46.7%) had a progressive disease, and at 6 months, the number of patients having progressive disease increased to 36 (60%). Six-month mortality did not show a significant association with age, gender, stage, or mean duration of complaints. However, a significant association with a mean number of drug cycles and mean compliance rate was observed. Conclusions: Combination gemcitabine and cisplatin which is the standard first-line therapy in advanced gallbladder carcinoma patients showed limited response in the Indian patients, leading to invariable disease progression by 6 months.

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