THE COMPARISON OF EFFICACY BETWEEN CAPECITABINE AND CISPLATIN REGIMEN VERSUS GEMCITABINE AND CISPLATIN REGIMEN, AS PALLIATIVE CHEMOTHERAPY FOR ADVANCED BILIARY TRACT CARCINOMA

Dr. Md. Tariq Hasan*, Dr. Md. Nazmul Hasan, Dr. Md. Abdullah –Al-Maruf, Dr. Mohammed Mostanshir Billah, Dr. Md. Zillur Rahman Bhuiyan and Dr. Sarwar Alam

ABSTRACT

Background: Biliary tract cancers refer to as group of cancers that arise from epithelial lining of the gall bladder and bile ducts perihilar and extra hepatic biliary tree and periampullary tumors. Though biliary tract cancer is a rare entity. Objective: In this study our main goal is to evaluate the efficacy between Capecitabine and Cisplatin regimen versus Gemcitabine and Cisplatin regimen, as palliative chemotherapy for advanced biliary tract carcinoma. Method: This quasi-experimental study were conducted in Department of Oncology Bangabandhu Sheikh Mujib Medical University, Dhaka Medical College and National Institute of Cancer Research and Hospital, Dhaka from January 2018 to June 2019. 78 patients with advanced biliary tract carcinoma (Stage IV), attending the out-Patient department were selected as sample in both arms, in arm A 39 patients and in arm B 39 patients. Where Arm A patients received - Oral Capecitabine 1250 mg/m2 twice daily on days 1–14 plus Cisplatin 60 mg/m2, 2 hour infusion with proper hydration on day 2 every 3 weeks for 6 cycles and Arm B patients received - Gemcitabine 1250 mg/m2 by 30 minute infusion on days 1, 8 plus Cisplatin 75mg/m2 2 hour infusion with proper hydration on day 1 every 3 weeks for 6 cycles. Results: Most of the patients in both the arms suffered from Grade1 and 2 anemia. It was 41.02% in Arm A and 51.28% in Arm B. Grade 2 anemia was experienced by 12.83% of the Arm A and 28.20% of the Arm B patients. Grade 3 anemia was experienced by 7.69% of the Arm B patients.64.10% patients from Arm A and 58.98% patients from Arm B did not suffer from fatigue. 25.64% and 30.76% patients from Arm A and Arm B suffered from Grade1. And also10.26% in Arm A and 10.26% in Arm B Grade 2 fatigue respectively. most of the patients in both the arms suffered from Grade1 and 2 Anorexia. It was 64.10% in Arm A and 53.85% in Arm B. Grade 2 Anorexia was experienced by 33.34% of the Arm A and 38.47% of the Arm B patients. Only 1 patient of the Arm A and 3 patients of the Arm B patients did not have anorexia during the treatment period. Conclusion: We can say that treatment with Capecitabine-Cisplatin regimen is quiteeffective and convenient in palliation of symptoms and loco regional control of advanced biliary tract cancer.

Keywords: Advanced biliary tract carcinoma, palliative chemotherapy.