Department of Medical Oncology, Georges Francois Leclerc Cancer Center, Dijon, France.
Anticancer Res. 2012 Sep;32(9):4125-30.
Metastatic pancreatic carcinoma is an incurable disease and gemcitabine remains the standard of care in first-line chemotherapy. Recently, fluorouracil/leucovorin combined with irinotecan and oxaliplatin (FOLFIRINOX) demonstrated their superiority in first-line therapy. The objective of this study was to determine the efficacy of FOLFIRINOX in either first- and second-line treatment and to compare its efficacy in regard to the location of the primary tumor.
We performed a retrospective analysis of clinical factors associated with patients' survival using a cohort of 42 patients treated by FOLFIRINOX in either first- or second-line (2006-2011) and a control cohort of 42 patients matched on sex and age without FOLFIRINOX treatment was obtained from a previous period of time (2001-2005).
The median follow-up was 10 months. The median overall survival was 10 months for the whole cohort and 10 and 12 months for patients treated at first- and second-line, respectively (p<0.05). In this cohort using a multivariate model, among classical prognosis factors, only primary location in the head was associated with poor outcome. The median overall survival was 8 months for patients with primary location in the head and 14 months for patients with primary location in the corpse or tail (p=0.02). In the gemcitabine cohort, the median follow-up was 8 months. Using a multivariate model, only performance status was associated with outcome. The median overall survival was 9 versus 6.5 months for patients with tumor, of the head versus tail or corpse tumor respectively (p<0.05).
This retrospective study suggests the same efficacy of FOLFIRINOX used either in first- or second- line therapy for pancreatic cancer. Importantly, FOLFIRINOX compared favorably to gemcitabine only for patients with tumor of the corpse or tail. Further prospective trials are warranted to evaluate the efficacy of FOLFIRINOX in patients with tumor of the head of the pancreas.
转移性胰腺癌是一种无法治愈的疾病，吉西他滨仍然是一线化疗的标准治疗方法。最近，氟尿嘧啶/亚叶酸钙联合伊立替康和奥沙利铂（FOLFIRINOX）在一线治疗中显示出其优越性。本研究的目的是确定 FOLFIRINOX 在一线和二线治疗中的疗效，并比较其在原发肿瘤位置方面的疗效。
我们对 42 例接受 FOLFIRINOX 一线或二线治疗的患者（2006-2011 年）的临床因素与生存相关进行回顾性分析，并从先前时间段（2001-2005 年）获得了 42 例匹配性别和年龄但未接受 FOLFIRINOX 治疗的对照组患者的临床因素与生存相关。
中位随访时间为 10 个月。全队列的中位总生存期为 10 个月，一线和二线治疗的患者分别为 10 个月和 12 个月（p<0.05）。在本队列中，使用多变量模型，在经典预后因素中，只有原发部位在头部与不良预后相关。原发部位在头部的患者中位总生存期为 8 个月，原发部位在体部或尾部的患者中位总生存期为 14 个月（p=0.02）。在吉西他滨组中，中位随访时间为 8 个月。使用多变量模型，只有体能状态与结局相关。肿瘤位于头部的患者中位总生存期为 9 个月，而肿瘤位于体部或尾部的患者中位总生存期为 6.5 个月（p<0.05）。
这项回顾性研究表明，FOLFIRINOX 无论是一线还是二线治疗胰腺癌的疗效相同。重要的是，FOLFIRINOX 仅对体部或尾部肿瘤的患者比吉西他滨更有利。需要进一步的前瞻性试验来评估 FOLFIRINOX 在胰腺头部肿瘤患者中的疗效。
