A phase II study of stereotactic radiotherapy after FOLFIRINOX for locally advanced pancreatic cancer (LAPC-1 trial): Long-term outcome

A phase II study of stereotactic radiotherapy after FOLFIRINOX for locally advanced pancreatic cancer (LAPC-1 trial): Long-term outcome
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DOI:
10.1016/j.radonc.2020.11.006
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发表时间:
2021-02-01
影响因子:
5.7
通讯作者:
Nuyttens, J. J.
Nuyttens, J. J.
中科院分区:
医学1区
文献类型:
--
作者:
Teriaca, M. A.;Loi, M.;Nuyttens, J. J.

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目的:报告局部晚期胰腺癌(LAPC)患者使用FOLFIRINOX进行立体定向放射治疗(LAPC-1试验)的多中心II期研究的长期结果。材料与方法:纳入组织学证实诊断时不能手术的LAPC患者。给予8个周期的FOLFIRINOX诱导治疗。如果化疗后未发现疾病进展,患者接受立体定向全身放疗(SBRT),总剂量为40 Gy,分5次进行。结果:在LAPC-1试验中,纳入了50例患者,但由于11例患者在化疗期间疾病进展,39例患者在FOLFIRINOX治疗后接受了立体定向SBRT。在整个人群中,1年和3年总生存率(OS)分别为62%和10%。中位随访时间为13个月。SBRT组的中位生存期为18个月(95% CI 13.2-21.5),而非SBRT组的中位生存期为5个月(95% CI 4.1-6.7) (SBRT期间不良事件p= 3)。结论:在接受FOLFIRINOX和SBRT治疗的LAPC患者中发现了长期生存。这种方法增加了根治性手术的可能性。与未切除组相比,切除组患者的生存率明显提高。(C) 2020 Elsevier B.V.版权所有
Purpose: To report the long-term outcome of a multicenter phase II study with FOLFIRINOX followed by stereotactic body radiotherapy (LAPC-1 trial) in patients with locally advanced pancreatic cancer (LAPC). Materials and methods: Patients with histological confirmation of LAPC inoperable at diagnosis were enrolled. Induction therapy with 8 cycles of FOLFIRINOX was administered. If no disease progression was found after chemotherapy, patients received stereotactic body radiotherapy (SBRT) at a total dose of 40 Gy in 5 fractions. Results: In LAPC-1 trial, 50 patients were included, but due to disease progression in 11 patients under chemotherapy, 39 patients received stereotactic SBRT after FOLFIRINOX treatment. In whole population, the 1- and 3-year overall survival (OS) were 62% and 10%, respectively. Median follow-up was 13 months. The SBRT group had median OS of 18 months (95% CI 13.2-21.5) versus 5 months (95% CI 4.1-6.7) in non-SBRT group (p= 3 adverse events during SBRT. Conclusions: Long-term survival has been found in patients with LAPC underwent FOLFIRINOX followed by SBRT. This approach increased the probability of a radical surgery. The resected patients achieved a significant better survival compared to unresected group. (C) 2020 Elsevier B.V. All rights reserved.