Varzaru Bianca, Iacob Razvan A, Croitoru Adina E, Iacob Speranta M, Radu Cristina E, Dumitrescu Stefania M, Gheorghe Cristian
Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Gastroenterology Department, Sanador Clinical Hospital, 010991 Bucharest, Romania.
Cancers (Basel). 2023 Jul 5;15(13):3500. doi: 10.3390/cancers15133500.
To assess the efficacy of FOLFIRINOX(FFX), gemcitabine-based regimens (GB), and gemcitabine monotherapy (Gem) in patients with metastatic pancreatic ductal adenocarcinoma (mPDAC).
This is a retrospective study that included 83 patients with mPDAC treated with first-line chemotherapy (L1) with either FFX, GB or Gem between 2015 and 2017. Progression-free survival (PFS) for L1 and second-line chemotherapy (L2) (PFS-L1 and PFS-L2) and overall survival (OS) were estimated using the Kaplan-Meier method.
Median PFS-L1 for FFX, GB and Gem groups was 9 months (95% (Confidence Interval) CI 2.76-15.24), 5 months (95%CI 3.44-6.56), and 5 months (95%CI 3.76-6.24), respectively ( = 0.04). OS was 14 months (95%CI 11.16-16.85), 12 months (95%CI: 9.44-11.56), and 7 months (95%CI: 5.7-8.3) for patients treated with FFX, GB, and Gem, respectively ( = 0.0001). ECOG-PS (0/1) (Hazard Ratio (HR) 6.74, = 0.002), age > 70 years (HR 0.25, = 0.04), body tumors (HR 2.8, = 0.048), CA19-9 > 39 U/mL (HR 0.26, = 0.02), and neutrophil-to-lymphocyte ratio (NLR) > 4.15 (HR 6.76, = 0.001) were independent prognostic factors for PFS-L1. Male gender (HR 3.02, = 0.026), ECOG-PS (0/1) (HR 4.21, = 0.003), L1 with FFX (HR 0.255, = 0.007), and NLR > 4.15 (HR 2.65, = 0.04) were independent prognostic factors of OS. PFS-L2 (HR 6.91, = 0.013) and OS-L2 (HR 6.95, = 0.037) were significantly higher in patients first treated with FFX.
The OS of patients who receive FFX or GB is comparable. The best PFS-L1 belongs to the FFX group. Male gender, ECOG-PS 0/1, the FFX regimen, and NLR > 4.15 were independent predictors of OS. PFS-L2 and OS-L2 were favorably impacted by L1 with FFX.
评估FOLFIRINOX（FFX）、吉西他滨方案（GB）及吉西他滨单药治疗（Gem）对转移性胰腺导管腺癌（mPDAC）患者的疗效。
这是一项回顾性研究，纳入了2015年至2017年间接受一线化疗（L1）的83例mPDAC患者，治疗方案为FFX、GB或Gem。采用Kaplan-Meier法估计L1和二线化疗（L2）的无进展生存期（PFS）（PFS-L1和PFS-L2）以及总生存期（OS）。
FFX组、GB组和Gem组的PFS-L1中位数分别为9个月（95%置信区间（CI）2.76 - 15.24）、5个月（95%CI 3.44 - 6.56）和5个月（95%CI 3.76 - 6.24）（P = 0.04）。接受FFX、GB和Gem治疗的患者OS分别为14个月（95%CI 11.16 - 16.85）、12个月（95%CI：9.44 - 11.56）和7个月（95%CI：5.7 - 8.3）（P = 0.0001）。东部肿瘤协作组体能状态（ECOG-PS）为0/1（风险比（HR）6.74，P = 0.002）、年龄>70岁（HR 0.25，P = 0.04）、存在体部肿瘤（HR 2.8，P = 0.048）、糖类抗原19-9（CA19-9）>39 U/mL（HR 0.26，P = 0.02）以及中性粒细胞与淋巴细胞比值（NLR）>4.15（HR 6.76，P = 0.001）是PFS-L1的独立预后因素。男性（HR 3.02，P = 0.026）、ECOG-PS为0/1（HR 4.21，P = 0.003）、L1采用FFX方案（HR 0.255，P = 0.007）以及NLR>4.15（HR 2.65，P = 0.04）是OS的独立预后因素。首次接受FFX治疗的患者，PFS-L2（HR 6.91，P = 0.013）和OS-L2（HR 6.95，P = 0.037）显著更高。
接受FFX或GB治疗患者的OS相当。FFX组的PFS-L1最佳。男性、ECOG-PS为0/1、FFX方案以及NLR>4.15是OS的独立预测因素。L1采用FFX对PFS-L2和OS-L2有积极影响。
