Tsujie Masanori, Fumita Soichi, Ishikawa Hajime, Kitani Kotaro, Satoi Shumpei, Fukuda Shuichi, Manabe Hironobu, Akashi Yusaku, Wakasa Tomoko, Shiono Hiroyuki, Tamura Takao, Yukawa Masao, Inoue Masatoshi
Dept. of Surgery, Kindai University Nara Hospital.
Gan To Kagaku Ryoho. 2019 Aug;46(8):1259-1263.
We retrospectively analyzed adverse effects(AEs), overall survival(OS), and progression-free survival(PFS)in 15 consecutive patients treated with FOLFIRINOX as the first-line treatment for recurrent or unresectable pancreatic ductal adenocarcinoma( PDAC)between February 2014 and December 2017 in our hospital. Eleven patients were treated for unresectable PDAC with distant metastases(UR-M), and 4 were treated for locally advanced unresectable PDAC(UR-LA). The median age was 56(range: 40-75)years. Nine patients were male, and 6 were female. The performance status was 0 or 1 in all patients. Tumors were located in the pancreas head in 8 cases and in the body-tail in 7 cases. Grade 5 AEs were observed in 1 case in which liver abscess causing sepsis resulted in mortality. The response rate was 20.0%, and the disease control rate was 66.7%. Two patients underwent conversion surgery after FOLFIRINOX treatment. Seven patients received a nab-paclitaxel plus gemcitabine regimen as second-line treatment. The median OS and PFS were 17.0 and 8.4 months, respectively, and the 1-year survival rate was 66.7%. FOLFIRINOX for recurrent and unresectable PDAC showed relatively good tumor control. However, strict attention is required for severe AEs. Conversion surgery might be effective in patients who are good responders even if they have metastatic disease.
我们回顾性分析了2014年2月至2017年12月在我院接受FOLFIRINOX作为复发性或不可切除胰腺导管腺癌（PDAC）一线治疗的15例连续患者的不良反应（AE）、总生存期（OS）和无进展生存期（PFS）。11例患者接受不可切除的伴有远处转移的PDAC（UR-M）治疗，4例接受局部晚期不可切除的PDAC（UR-LA）治疗。中位年龄为56岁（范围：40 - 75岁）。9例为男性，6例为女性。所有患者的体能状态均为0或1。肿瘤位于胰头8例，位于体尾部7例。观察到1例5级AE，因肝脓肿导致败血症死亡。缓解率为20.0%，疾病控制率为66.7%。2例患者在FOLFIRINOX治疗后接受了转化手术。7例患者接受白蛋白结合型紫杉醇加吉西他滨方案作为二线治疗。中位OS和PFS分别为17.0个月和8.4个月，1年生存率为66.7%。FOLFIRINOX用于复发性和不可切除的PDAC显示出相对较好的肿瘤控制。然而，对于严重AE需要严格关注。即使有转移性疾病，转化手术对反应良好的患者可能有效。
