Department of Oncology, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Department of Oncology, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Clin Colorectal Cancer. 2018 Sep;17(3):187-197. doi: 10.1016/j.clcc.2018.03.007. Epub 2018 Mar 14.
We performed a meta-analysis of previous reports evaluating the effect of mFIO (modified FOLFIRINOX; leucovorin, 5-fluorouracil, irinotecan, oxaliplatin) regimens in advanced pancreatic cancer.
We performed a meta-analysis of reported studies in PubMed, Scopus, and Web of Science (1950-2016) in December 2016. The inclusion criteria were randomized trials, prospective or retrospective cohorts, patients with metastatic pancreatic adenocarcinoma, the use of mFIO or FOLFIRINOX (FIO) chemotherapy, and available information for ≥ 1 efficacy endpoint (response rate, progression-free survival, and/or overall survival). The outcomes were compared according to the chemotherapy regimen using a random effects model. We also performed a meta-regression analysis to evaluate the effect of dose reductions on outcomes.
Of 2525 abstracts, 32 were considered eligible. Modifications in the FIO regimen included omission of the 5-fluorouracil bolus and/or dose reductions in infusional 5-fluorouracil, irinotecan, and/or oxaliplatin. mFIO was not associated with inferior response rates (32% vs. 33%; P = .879), lower rates of survival at 11 months (47% vs. 50%; P = .38), or lower 6-month progression-free survival rates (47% vs. 53%; P = .38). The meta-regression of the percentage of dose reduction failed to show any association.
The results of the present meta-analysis with a combined sample size of 1461 patients suggest that it is reasonable to consider mFIO regimens for patients with metastatic pancreatic adenocarcinoma.
我们对评估改良 FOLFIRINOX（改良 FOLFIRINOX；亚叶酸、5-氟尿嘧啶、伊立替康、奥沙利铂）方案在晚期胰腺癌中的疗效的既往报告进行了荟萃分析。
我们于 2016 年 12 月在 PubMed、Scopus 和 Web of Science 中对报告的研究进行了荟萃分析（1950-2016 年）。纳入标准为随机试验、前瞻性或回顾性队列研究、转移性胰腺腺癌患者、使用 mFIO 或 FOLFIRINOX（FIO）化疗以及有≥1 个疗效终点（缓解率、无进展生存期和/或总生存期）的可用信息。使用随机效应模型根据化疗方案比较结果。我们还进行了荟萃回归分析以评估剂量减少对结果的影响。
在 2525 篇摘要中，有 32 篇被认为符合条件。FIO 方案的修改包括省略氟尿嘧啶推注和/或减少氟尿嘧啶持续输注、伊立替康和/或奥沙利铂的剂量。mFIO 与较低的缓解率（32%对 33%；P=.879）、11 个月时的生存率（47%对 50%；P=.38）或 6 个月时的无进展生存率（47%对 53%；P=.38）无关联。剂量减少百分比的荟萃回归未能显示出任何关联。
本荟萃分析的结果结合了 1461 例患者的样本量，表明对于转移性胰腺腺癌患者，考虑使用 mFIO 方案是合理的。
