Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Zhejiang Provincial Key Laboratory of Pancreatic Disease, Hangzhou, China.
Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Cancer Lett. 2017 Oct 10;406:22-26. doi: 10.1016/j.canlet.2017.07.012. Epub 2017 Jul 17.
FOLFIRINOX chemotherapy has shown remarkable responses in patients with metastatic pancreatic cancer (MPC), and has significantly improved prognosis. However, FOLFIRINOX is currently not frequently applied in China because of its high incidence of adverse events, and there is no recognized optimization for this therapy in Chinese population. Modification of FOLFIRINOX may be better for its acceptance in China. In this study, we evaluated the efficacy and safety of modified-FOLFIRINOX in patients with MPC. A total of 62 MPC patients were treated with modified-FOLFIRINOX (no Fluorouracil bolus, 85% Oxaliplatin and 75% Irinotecan) between April 2014 and April 2017 in our institute. 40 of them were evaluated, with a response rate of 32.5% (13/40). The frequent grade 3/4 adverse events are neutropenia (29%) and alanine aminotransferase elevation (14.5%). No treatment-related death was observed. The median overall survival and median progression-free survival are 10.3 months and 7.0 months, respectively. In conclusion, modified-FOLFIRINOX had significantly improved tolerance with similar efficacy to FOLFIRINOX. These findings may provide evidence for the use of FOLFIRINOX in Chinese patients with MPC.
FOLFIRINOX 化疗在转移性胰腺癌（MPC）患者中显示出显著的反应，并显著改善了预后。然而，由于其不良反应发生率高，FOLFIRINOX 目前在中国并未广泛应用，而且针对中国人种，该疗法也没有得到认可的优化方案。因此，对 FOLFIRINOX 进行改良可能更有利于在中国的接受度。在本研究中，我们评估了改良 FOLFIRINOX 治疗 MPC 患者的疗效和安全性。2014 年 4 月至 2017 年 4 月期间，我院共对 62 例 MPC 患者采用改良 FOLFIRINOX（无氟尿嘧啶推注，奥沙利铂 85%，伊立替康 75%）治疗，其中 40 例可评估，客观缓解率为 32.5%（13/40）。常见的 3/4 级不良反应为中性粒细胞减少（29%）和丙氨酸氨基转移酶升高（14.5%）。无治疗相关死亡。中位总生存期和中位无进展生存期分别为 10.3 个月和 7.0 个月。总之，改良 FOLFIRINOX 具有更好的耐受性，疗效与 FOLFIRINOX 相似。这些发现可能为中国 MPC 患者使用 FOLFIRINOX 提供依据。
