5-氟尿嘧啶、亚叶酸钙、伊立替康和奥沙利铂作为一线方案治疗潜在可切除和局部晚期胰腺癌荟萃分析

FOLFIRINOX as a first line therapy in locally advanced pancreatic cancer and borderline resectable pancreatic cancer： a Meta-analysis

目的评价以5-氟尿嘧啶、亚叶酸钙、伊立替康和奥沙利铂（FOLFIRINOX方案）作为一线方案治疗潜在可切除（BRPC）和局部不可切除胰腺癌（LAPC）的有效性。方法符合条件的文献均来自PubMed、Cochrane Library、EMBASE。分析手术切除率和根治性（R0）切除率。数据表示为具有95％可信区间（95％C／）的加权合并比例。结果共纳入14项研究，包含了408例患者。在一线FOLFIRINOX治疗后，手术切除率为42．0％（95％CI：28．0％-56．0％），根治性（R0）切除率为41．0％（95％CI：37．0％～45．0％），中位总生存期范围15．5—35．4个月，中位无进展生存期10—17．8个月。结论作为一线方案，FOLFIRINOX化疗对潜在可切除和局部晚期胰腺癌患者疗效显著，毒副反应可控。

Objective To evaluate the efficacyof the first line chemotherapy FOLFIRINOX （5-Fu, Leucovorin calcium, Irinoteean, Oxaliplatin） as the treatment of pancreatic cancer. Methods Pertinent studies were identified from the PubMed, Cochrane Library and EMBASE. The outcomes were resection rate and radical （RO） resection rate were analyzed. Data were expressed as weighted pooled proportions with 95% confidence intervals （95% CI）. Results There were thirteen studies with 408 patients with LAPC and BRPC included. After the treatment, 42. 0% （95% CI： 28.0% -56. 0% ） tumorswere resected and 41.0% （95% CI： 37.0% -45.0% ） were underwentRO resection, and median overall survival ranged from 15.5 to 34.5 months, median progression-free survival ranged fi＇om 10.0 to 17.8 months. Conclusion The meta-analysis shows that down-staging after first line FOLFIRINOX-based therapy is noticeable in patients with borderline resectable/unresectable PC, and the adverse events were in control.