Papaxoinis George, Athanasiadis Athanasios, Sgouros Joseph, Visvikis Anastastios, Drizou Maria, Kontopodis Emmanouil, Koumarianou Anna, Stojanovska Suzana, Aravantinos Gerasimos, Korantzis Ippokratis, Ioannou Alexandros, Varthalitis Ioannis, Doufexis Dimitrios, Nikolaou Michail, Lypas Georgios, Bompolaki Iliada, Christopoulou Athina, Liontos Michael, Tsoukalas Nikolaos, Mauri Davide, Xenidis Nikolaos, Katsaounis Panagiotis, Oikonomopoulos Georgios, Boukovinas Ioannis
Hellenic Society of Medical Oncology (HeSMO), Athens, Greece.
J Oncol. 2020 Sep 19;2020:5304516. doi: 10.1155/2020/5304516. eCollection 2020.
During the last decade, significant improvement was made in systemic therapy of pancreatic adenocarcinoma (PAC). The impact of this progress in everyday clinical practice has not been fully described yet. The aim of the study was to investigate the pattern followed by Greek Medical Oncologists regarding the treatment of patients with PAC.
This observational, noninterventional multicenter study recorded clinical data from the files of 200 active patients (alive and under treatment or follow-up) for a two-year period (November 2015 until November 2017) from 20 oncology centers around Greece.
In total, 51 (25.5%) patients underwent radical surgical resection of PAC, and 40 (78.4%) of them received adjuvant and 1 (2.0%) neoadjuvant chemotherapy. The median time to recurrence was 7.9 months, and median overall survival (OS), 20.2 months. First-line chemotherapy was administered to 193 (96.5%) patients. The majority of patients were treated with the combination of nab-paclitaxel-gemcitabine (NPG), 5-fluorouracil, leucovorin, irinotecan, oxaliplatin (FOLFIRINOX), or gemcitabine monotherapy. Of them, 39.5% responded to the treatment. Median OS and PFS were 14.1 months and 7.0 months, respectively. Second-line treatment was administered to 112 patients. The majority received NPG, FOLFIRINOX/capecitabine, oxaliplatin, irinotecan (CAPOXIRI), or 5-fluorouracil, leucovorin, oxaliplatin (FOLFOX)/capecitabine, oxaliplatin (CAPOX). Median OS with second-line treatment was 8.6 months, and median PFS, 5.5 months. The most common chemotherapy sequences were NPG as first-line followed by FOLFIRINOX/CAPOXIRI as second-line, NPG followed by FOLFOX/CAPOX, NPG followed by other regimens, and FOLFIRINOX/CAPOXIRI followed by NPG.
This study described the significant improvement in prognosis of PAC patients receiving palliative chemotherapy and the relatively high rate of receipt of second-line chemotherapy, according to real-world data. However, due to the nonrandomized nature of the study, any comparison between different chemotherapy regimens should be regarded with caution.
在过去十年中，胰腺腺癌（PAC）的全身治疗取得了显著进展。然而，这一进展在日常临床实践中的影响尚未得到充分描述。本研究的目的是调查希腊肿瘤内科医生对PAC患者的治疗模式。
这项观察性、非干预性多中心研究记录了来自希腊各地20个肿瘤中心的200例活跃患者（存活且正在接受治疗或随访）在两年期间（2015年11月至2017年11月）的临床资料。
共有51例（25.5%）患者接受了PAC根治性手术切除，其中40例（78.4%）接受了辅助化疗，1例（2.0%）接受了新辅助化疗。复发的中位时间为7.9个月，总生存期（OS）的中位时间为20.2个月。193例（96.5%）患者接受了一线化疗。大多数患者接受了白蛋白结合型紫杉醇-吉西他滨（NPG）、5-氟尿嘧啶、亚叶酸钙、伊立替康、奥沙利铂（FOLFIRINOX）联合治疗，或吉西他滨单药治疗。其中，39.5%的患者对治疗有反应。OS和无进展生存期（PFS）的中位时间分别为14.1个月和7.0个月。112例患者接受了二线治疗。大多数患者接受了NPG、FOLFIRINOX/卡培他滨、奥沙利铂、伊立替康（CAPOXIRI），或5-氟尿嘧啶、亚叶酸钙、奥沙利铂（FOLFOX）/卡培他滨、奥沙利铂（CAPOX）治疗。二线治疗的OS中位时间为8.6个月，PFS中位时间为5.5个月。最常见的化疗顺序是NPG作为一线治疗，随后是FOLFIRINOX/CAPOXIRI作为二线治疗、NPG随后是FOLFOX/CAPOX、NPG随后是其他方案，以及FOLFIRINOX/CAPOXIRI随后是NPG。
根据真实世界数据，本研究描述了接受姑息化疗的PAC患者预后的显著改善以及二线化疗的相对高接受率。然而，由于本研究的非随机性质，不同化疗方案之间的任何比较都应谨慎对待。
