5-Fluorouracil/Leucovorin Combined with Irinotecan and Oxaliplatin (FOLFIRINOX) as Second-Line Chemotherapy in Patients with Metastatic Pancreatic Adenocarcinoma
5-Fluorouracil/Leucovorin Combined with Irinotecan and Oxaliplatin (FOLFIRINOX) as Second-Line Chemotherapy in Patients with Metastatic Pancreatic Adenocarcinoma
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DOI：
10.1159/000329803
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发表时间：
2011-01-01
期刊：
影响因子：
3.5
通讯作者：
Culine, Stephane
中科院分区：
文献类型：
--
作者：
Assaf, Elias;Verlinde-Carvalho, Muriel;Culine, Stephane
背景资料：评价伊立替康、奥沙利铂联合5-氟尿嘧啶（FU）和亚叶酸钙（FOLFIRINOX）二线治疗转移性胰腺癌（MPA）的疗效和毒性。患者和方法：我们回顾性分析了2003年1月至2009年11月在我院接受FOLFIRINOX二线治疗的27例MPA患者的病历。推荐方案为第1天奥沙利铂85 mg/m2+第1天伊立替康180 mg/m2+第1天甲酰四氢叶酸400 mg/m2，随后第1天FU 400 mg/m2推注，每2周2次2,400 mg/m2持续输注46小时。结果：27例患者（男13例，女14例）的中位年龄为63岁（45-83岁）。所有患者在吉西他滨一线化疗后均出现疾病进展。共给药167个周期，每例患者的中位周期数为6个周期（1-29）。发生1例中毒性死亡（败血症）。治疗耐受性可接受，奥沙利铂、伊立替康和FU每例患者的相对剂量密度分别为92.8%、89.1%和96.4%。55.6%的患者发生3-4级中性粒细胞减少，包括1例发热性中性粒细胞减少。其他毒性是可控的。关于疗效，27例患者中有22例可评价（WHO和RECIST标准）。5名患者部分缓解，12名患者病情稳定，总体疾病控制率为63%。中位进展时间为5.4个月（0.7-25.48），中位无事件生存期为3个月（0.5-24.9）。中位总生存期为8.5个月（0-26）。55%的患者报告了临床获益。结论：这些结果证实了FOLFIRINOX方案作为MPA二线治疗的良好安全性和疗效。版权所有（C）2011 S. Karger AG，巴塞尔
Background: To evaluate the efficacy and toxicity of irinotecan and oxaliplatin plus 5-fluorouracil (FU) and leucovorin (FOLFIRINOX) as second-line therapy in metastatic pancreatic adenocarcinoma (MPA). Patients and Methods: We retrospectively analyzed the medical records of 27 patients with MPA treated with FOLFIRINOX as second-line therapy between January 2003 and November 2009 in our hospital. The recommended schedule was oxaliplatin 85 mg/m(2) on day 1 + irinotecan 180 mg/m(2) on day 1 + leucovorin 400 mg/m(2) on day 1 followed by FU 400 mg/m(2) as a bolus on day 1 and 2,400 mg/m(2) as 46-hour continuous infusion biweekly. Results: The median age of the 27 patients (13 males and 14 females) was 63 years (45-83). All patients had progressive disease after first-line chemotherapy by gemcitabine. A total of 167 cycles were administered, with a median number of 6 cycles (1-29) per patient. One toxic death occurred (sepsis). Tolerance of treatment was acceptable, and the relative dose density delivered per patient was 92.8% for oxaliplatin, 89.1% for irinotecan and 96.4% for FU. Grade 3-4 neutropenia occurred in 55.6% of the patients, including 1 febrile neutropenia. The other toxicities were manageable. Regarding efficacy, 22 of the 27 patients were evaluable (WHO and RECIST criteria). Five patients had partial responses and 12 stable disease, resulting in an overall disease control rate of 63%. Median time to progression was 5.4 months (0.7-25.48), and median event-free survival was 3 months (0.5-24.9). Median overall survival was 8.5 months (0-26). A clinical benefit was reported for 55% of the patients. Conclusions: These results confirmed the good safety profile and the efficacy of the FOLFIRINOX regimen as second-line treatment of MPA. Copyright (C) 2011 S. Karger AG, Basel