Department of Hepatobiliary and Pancreatic Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-Ku, Osaka, 541-8567, Japan.
Department of Nursing, Osaka International Cancer Institute, Osaka, Japan.
BMC Cancer. 2023 Jul 31;23(1):711. doi: 10.1186/s12885-023-11205-6.
Nanoliposomal irinotecan (nal-IRI) plus 5-fluorouracil (5-FU)/levo-leucovorin (Levo-LV) was approved for unresectable pancreatic cancer (UR-PC) in March 2020 in Japan. Levo-LV is administered by intravenous infusion over 120 min following 90 min intravenous infusion of nal-IRI (conventional method), causing a significant burden on both patients and the outpatient chemotherapy room owing to the prolonged administration time. Thus, from July 2021, we introduced the simultaneous intravenous administration of nal-IRI and Levo-LV (parallel method) with the approval of the institutional regimen committee.
We retrospectively reviewed the data of 69 patients with UR-PC who received nal-IRI plus 5-FU/Levo-LV at our hospital between June 2020 and October 2021. We examined the safety of the parallel method and compared the treatment outcomes and administration times between the two methods.
The median age was 66 years (54%, male). Disease statuses were locally advanced, metastatic, and postoperative recurrence after pancreatectomy in 7, 50, and 12 patients, respectively. Nal-IRI plus 5-FU/Levo-LV treatment was second and third-line or later in 35 and 34 patients, respectively. No intravenous line problems were observed during the parallel administration of nal-IRI and Levo-LV. Although there were no significant differences in response rates and adverse events between the two methods, the administration time was significantly shorter in the parallel method than in the conventional method.
The parallel administration of nal-IRI and Levo-LV is clinically safe and not inferior in efficacy. Moreover, parallel administration may offer convenience to patients and healthcare workers by reducing administration time.
纳米脂质体伊立替康（nal-IRI）联合 5-氟尿嘧啶（5-FU）/左亚叶酸（Levo-LV）于 2020 年 3 月在日本获批用于不可切除的胰腺癌（UR-PC）。Levo-LV 是在 nal-IRI 静脉输注 90 分钟后通过静脉输注 120 分钟给予的（常规方法），由于给药时间延长，给患者和门诊化疗室带来了很大的负担。因此，自 2021 年 7 月起，在机构治疗方案委员会的批准下，我们引入了 nal-IRI 和 Levo-LV 的同时静脉给药（并行方法）。
我们回顾性分析了 2020 年 6 月至 2021 年 10 月期间在我院接受 nal-IRI 联合 5-FU/Levo-LV 治疗的 69 例 UR-PC 患者的数据。我们检查了并行方法的安全性，并比较了两种方法的治疗结果和给药时间。
中位年龄为 66 岁（54%为男性）。疾病分期分别为 7 例局部晚期、50 例转移性和 12 例胰切除术后复发。nal-IRI 联合 5-FU/Levo-LV 治疗在 35 例和 34 例患者中分别为二线及以上和三线及以上治疗。nal-IRI 和 Levo-LV 并行给药期间未观察到静脉通路问题。虽然两种方法的缓解率和不良事件无显著差异，但并行方法的给药时间明显短于常规方法。
nal-IRI 和 Levo-LV 的并行给药在临床上是安全的，疗效不劣于常规方法。此外，并行给药可能通过减少给药时间为患者和医护人员提供便利。
