Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
J Surg Oncol. 2013 Sep;108(4):236-41. doi: 10.1002/jso.23392.
Trials examining FOLFIRINOX in metastatic pancreatic cancer demonstrate higher response rates compared to gemcitabine-based regimens. There is currently limited experience with neoadjuvant FOLFIRINOX in pancreatic cancer.
Retrospective review of outcomes of patients with borderline resectable or locally unresectable pancreatic cancer who were recommended to undergo neoadjuvant treatment with FOLFIRINOX.
FOLFIRINOX was recommended for 25 patients with pancreatic cancer, 13 (52%) unresectable and 12 (48%) borderline resectable. Four patients (16%) refused treatment or were lost to follow-up. Twenty-one patients (84%) were treated with a median of 4.7 cycles. Six patients (29%) required dose reductions secondary to toxicity. Two patients (9%) were unable to tolerate treatment and three patients (14%) had disease progression on treatment. Seven patients (33%) underwent surgical resection following treatment with FOLFIRINOX alone, 2 (10%) of which were initially unresectable. Two patients underwent resection following FOLFIRINOX + stereotactic body radiation therapy (SBRT). The R0 resection rate for patients treated with FOLFIRINOX ± SBRT was 33% (55% borderline resectable, 10% unresectable). A total of five patients (24%) demonstrated a significant pathologic response.
FOLFIRINOX is a biologically active regimen in borderline resectable and locally unresectable pancreatic cancer with encouraging R0 resection and pathologic response rates.
与吉西他滨为基础的方案相比，研究转移性胰腺癌的 FOLFIRINOX 试验显示出更高的缓解率。目前，新辅助 FOLFIRINOX 在胰腺癌中的应用经验有限。
回顾性分析建议接受新辅助 FOLFIRINOX 治疗的边界可切除或局部不可切除的胰腺癌患者的结局。
FOLFIRINOX 被推荐用于 25 例胰腺癌患者，其中 13 例（52%）不可切除，12 例（48%）边界可切除。4 例（16%）患者拒绝治疗或失访。21 例（84%）患者接受中位数为 4.7 个周期的治疗。6 例（29%）因毒性而需要减少剂量。2 例（9%）患者无法耐受治疗，3 例（14%）患者在治疗过程中出现疾病进展。7 例（33%）患者在单独接受 FOLFIRINOX 治疗后接受了手术切除，其中 2 例（10%）最初不可切除。2 例患者在接受 FOLFIRINOX+立体定向体部放射治疗（SBRT）后接受了手术切除。接受 FOLFIRINOX±SBRT 治疗的患者的 R0 切除率为 33%（55%边界可切除，10%不可切除）。共有 5 例（24%）患者表现出明显的病理性反应。
FOLFIRINOX 是一种在边界可切除和局部不可切除的胰腺癌中具有生物活性的方案，具有令人鼓舞的 R0 切除率和病理性反应率。
