改良FOLFIRINOX方案一线治疗晚期转移性胰腺癌

A New Modified FOLFIRINOX(mFOLFIRINOX)Regimen as First-Line Chemotherapy for Patient with Metastatic Pancreatic Adenocarcinoma(MPC)

【目的】探讨改良FOLFIRINOX(mFOLFIRINOX)方案为一线治疗晚期转移性胰腺癌的疗效和毒副反应。【方法】回顾性收集2012年12月至2016年12月在中山大学孙逸仙纪念医院接受mFOLFIRINOX方案化疗的20例晚期转移性胰腺癌患者资料,每3个化疗周期后进行影像学检查评估疗效,并观察相关毒副反应。mFOLFIRINOX方案为奥沙利铂60 mg/m^2,伊立替康150 mg/m^2,5-FU400 mg/m^2静脉推注、2 400 mg/m^2持续静脉输注。主要研究终点为中位生存时间,次要研究终点为客观缓解率以及不良反应发生率(中性粒细胞减少、恶心呕吐、腹泻、周围神经病)。【结果】20例患者中,4例患者因不符合入组标准被排除,共有16例患者可评价疗效。全组中位年龄为55岁(43~67岁),男性7例,女性9例。中位化疗周期为4.5个(3~15个)。5例获得部分缓解,9例稳定,2例进展,客观反应率为31.3%(5/16)。中位随访时间为14.1(2.7~24.5)个月,中位生存时间为16.6个月(95%CI,11.36~21.84),6个月、12个月的生存率分别为80%和55.6%。3例患者出现3-4级不良反应。【结论】mFOLFIRINOX方案一线治疗晚期转移性胰腺癌效果好,不良反应发生率较低。

【Objective】To investigate efficacy and toxicity of a new modified FOLFIRINOX regimen(mFOLFIRINOX)as first-line chemotherapy for the patients with metastatic pancreatic adenocarcinoma(MPC).【Methods】20patients with metastatic pancreatic adenocarcinoma(MPC)accepted mFOLFIRINOX arm(oxaliplatin60mg/m2,irinotecan150mg/m2,bolus of5-FU400mg/m2,continuous infusion of5-FU2400mg/m2)first-line treatment and evaluated the curative effect and side effect after3cycles by imaging and laboratory at Sun Yat-sen Memorial Hospital from December2012to December2016.The primary endpoint was overall survival(OS).The second endpoint was response rate(ORR)and toxicity.【Results】Four patients were excluded according to exclusion criteria.A total of16patients were enrolled including7males and9females.The median age is55years(ranging from43to67years).The median cycle of chemotherapy was4.5(3-15).The ORR was31.3%including5patients with partial response,9patients with stable diseaseand2patients with progression disease.The median follow-up duration was14.1(2.7-24.5)months.The median OS was16.6months(95%CI,11.36-21.84).Overall survival rates at6,12months were80%and55.6%,respectively.Three patients were presented grade3-4adverse events.【Conclusion】The new mFOLFIRINOX regimen improved survival of patients with MPC with tolerated toxicity as first line treatment.