Modified FOLFIRINOX for unresectable locally advanced or metastatic gallbladder cancer, a comparison with GEMOX regimen
Modified FOLFIRINOX for unresectable locally advanced or metastatic gallbladder cancer, a comparison with GEMOX regimen
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DOI：
10.21037/hbsn-20-846
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发表时间：
2021-03-03
影响因子：
8
通讯作者：
Liu, Ying-Bin
中科院分区：
文献类型：
--
作者：
Cui, Xu-Ya;Li, Xue-Chuan;Liu, Ying-Bin
背景：晚期胆囊癌（GBC）的一线化疗方案是吉西他滨加铂（GP），尽管其疗效有限。目前的研究是一项回顾性研究，比较改良的FOLFIRINOX （mFOLFIRINOX）和吉西他滨加奥沙利铂（GEMOX）作为一线化疗治疗不可切除的局部晚期或转移性GBC的安全性和有效性。方法：检索2014年4月至2018年4月在上海交通大学医学院附属新华医院接受mFOLFIRINOX或GEMOX作为一线治疗的局部晚期或转移性GBC患者的资料。本回顾性研究评估了临床特征、生存结局和不良事件。结果：共纳入44例患者（mFOLFIRINOX组25例，GEMOX组19例）。两组间基线特征无显著差异。mFOLFIRINOX组和GEMOX组的中位无进展生存期（mPFS）分别为5.0个月和2.5个月[P=0.021；风险比（HR）为0.499；95% CI, 0.266 ~ 0.937]。mFOLFIRINOX组的中位总生存期（mOS）为9.5个月，GEMOX组的中位总生存期（mOS）为7.0个月（P=0.019； HR, 0.471; 95% CI, 0.239 ~ 0.929）。mFOLFIRINOX组和GEMOX组的疾病控制率分别为76.0%和47.4% （P=0.051）。mFOLFIRINOX组3-4级不良事件发生率为48%，GEMOX组为36.8% （P=0.459）。mFOLFIRINOX组3-4级中性粒细胞减少症和腹泻发生率较高，而GEMOX组3-4级血小板减少症和周围神经病变发生率较高。结论：mFOLFIRINOX可能改善无法切除的局部晚期或转移性GBC的不良预后，结果需要进一步的前瞻性临床研究验证。
Background: The first-line chemotherapy regimen for advanced gallbladder cancer (GBC) is gemcitabine plus platinum (GP), despite its efficacy is limited. The current investigation is a retrospective study to compare the safety and efficacy between the modified FOLFIRINOX (mFOLFIRINOX) and gemcitabine plus oxaliplatin (GEMOX) as the first-line chemotherapy for unresectable locally advanced or metastatic GBC.Methods: The data of patients with unresectable locally advanced or metastatic GBC, who were treated with mFOLFIRINOX or GEMOX as the first-line therapy between April 2014 and April 2018 at Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, were retrieved. This retrospective study evaluated the clinical characteristics, survival outcomes and adverse events.Results: A total of 44 patients (n=25 in mFOLFIRINOX, n=19 in GEMOX) were included. There were no significant differences between groups in baseline characteristics. The median progression free survival (mPFS) was 5.0 months in the mFOLFIRINOX group and 2.5 months in the GEMOX group [P=0.021; hazard ratio (HR), 0.499; 95% CI, 0.266 to 0.937]. The median overall survival (mOS) was 9.5 months in the mFOLFIRINOX group and 7.0 months in the GEMOX group (P=0.019; HR, 0.471; 95% CI, 0.239 to 0.929). Disease control rate (DCR) was 76.0% in the mFOLFIRINOX group and 47.4% in the GEMOX group (P=0.051). The rate of grade 3-4 adverse events was 48% in the mFOLFIRINOX group and 36.8% in the GEMOX group (P=0.459). The incidence of grade 3-4 neutropenia and diarrhea were more common in the mFOLFIRINOX group, while the incidence of grade 3-4 thrombocytopenia and peripheral neuropathy were more common in the GEMOX group.Conclusions: mFOLFIRINOX might improve the poor prognosis of unresectable locally advanced or metastatic GBC, and the results need to be further verified by prospective clinical studies.