Medical School of Chinese People's Liberation Army (PLA), Beijing, China (mainland).
Department of Oncology, The Eighth Medical Center, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland).
Med Sci Monit. 2020 Oct 26;26:e927654. doi: 10.12659/MSM.927654.
BACKGROUND Pancreatic cancer (PC) is a common digestive system tumor. For patients with advanced pancreatic cancer (APC), chemotherapy is still the predominant treatment. However, no large-scale clinical studies have been done of it as first-line therapy for APC. The goal of the present study was to assess real-world outcomes with chemotherapy in that setting. MATERIAL AND METHODS We retrospectively analyzed data from 322 patients with APC who were treated with chemotherapy at 4 hospitals in different cities in China. The first-line regimens used were AS (nab-paclitaxel and S-1), AG (nab-paclitaxel and gemcitabine), and FOLFIRINOX (5-fluorouracil, leucovorin, irinotecan, and oxaliplatin). RESULTS Of the patients, 232 received AS, 79 received AG, and 11 received FOLFIRINOX. The median number of chemotherapy cycles was 5. The median overall survival (mOS) was 9 months and the median progression-free survival (mPFS) was 5 months. The AS, AG, and FOLFIRINOX regimens were associated with mOS rates of 9 months, 9 months, and 10 months, respectively. The mPFS rates for the AS, AG, and FOLFIRINOX regimens were 5, 4, and 5 months, respectively. The differences between the PFS rates for the regimens were statistically significant. The overall response rate (ORR) and overall disease control rate (DCR) for chemotherapy were 38% and 81.8%, respectively. The ORRs for the AS, AG, and FOLFIRINOX regimens were 46.9%, 18.7%, and 0%, respectively. The DCRs for the AS, AG and FOLFIRINOX regimens were 87.2%, 69.3%, and 63.6%, respectively. The differences between the ORRs and DCRs for the regimens were statistically significant. The incidences of grade 3/4 adverse events (AEs) associated with the AS, AG, and FOLFIRINOX regimens were 29.9%, 25%, and 36.4%, respectively. CONCLUSIONS The AS regimen was associated with a higher ORR and DCR than the other 2 regimens, with a lower rate of AEs.
胰腺癌（PC）是一种常见的消化系统肿瘤。对于晚期胰腺癌（APC）患者，化疗仍是主要治疗方法。然而，尚无大规模的临床研究将其作为 APC 的一线治疗。本研究旨在评估该环境下化疗的真实世界疗效。
我们回顾性分析了在中国 4 家不同城市的医院接受化疗治疗的 322 例 APC 患者的数据。一线方案为 AS（白蛋白紫杉醇联合替吉奥）、AG（白蛋白紫杉醇联合吉西他滨）和 FOLFIRINOX（氟尿嘧啶、亚叶酸钙、伊立替康和奥沙利铂）。
232 例患者接受 AS，79 例接受 AG，11 例接受 FOLFIRINOX。化疗周期中位数为 5 个。中位总生存期（mOS）为 9 个月，中位无进展生存期（mPFS）为 5 个月。AS、AG 和 FOLFIRINOX 方案的 mOS 率分别为 9 个月、9 个月和 10 个月。AS、AG 和 FOLFIRINOX 方案的 mPFS 率分别为 5、4 和 5 个月，方案间 PFS 率差异有统计学意义。化疗的总缓解率（ORR）和总疾病控制率（DCR）分别为 38%和 81.8%。AS、AG 和 FOLFIRINOX 方案的 ORR 分别为 46.9%、18.7%和 0%，DCR 分别为 87.2%、69.3%和 63.6%。方案间 ORR 和 DCR 差异有统计学意义。AS、AG 和 FOLFIRINOX 方案的 3/4 级不良事件（AE）发生率分别为 29.9%、25%和 36.4%。
AS 方案的 ORR 和 DCR 均高于其他 2 种方案，AE 发生率较低。
