Fluorouracil, doxorubicin, and streptozocin in the treatment of patients with locally advanced and metastatic pancreatic endocrine carcinomas
Fluorouracil, doxorubicin, and streptozocin in the treatment of patients with locally advanced and metastatic pancreatic endocrine carcinomas
复制标题
DOI：
10.1200/jco.2004.04.024
复制
发表时间：
2004-12-01
影响因子：
45.3
通讯作者：
Yao, JG
中科院分区：
文献类型：
--
作者：
Kouvaraki, MA;Ajani, JA;Yao, JG
目的全身化疗在胰腺内分泌癌（胰岛细胞癌）治疗中的作用是一个有相当大争议的领域。据报道，以链脲佐菌素为基础的化疗的反应率范围为6%至69%。我们回顾性研究了84例局部晚期或转移性PEC患者，这些患者接受了氟尿嘧啶、阿霉素和链脲佐菌素（FAS）治疗，以确定客观缓解率、无进展生存期（PFS），和总生存期（OS）患者和方法符合条件的患者在计算机断层扫描或磁共振成像扫描上具有其肿瘤和可测量疾病的组织学或细胞学确认。结果61例患者为男性，23例为女性，中位年龄54岁（24 ~ 78岁）。FAS的缓解率（RR）为39%，中位缓解持续时间为9.3个月。2年PFS率为41%，2年OS率为74%。肝转移性疾病的程度与较差的PFS（对数秩检验P = 0.01）和较差的OS（对数秩检验P <0.0001）相关。分析显示，超过75%的肝脏转移替代和既往化疗与PFS较差独立相关。结论局部晚期或转移性PEC患者接受FAS治疗可能具有合理的RR，应答者可能经历更长的PFS和OS。肝脏转移瘤体积是最重要的预后预测因素。(C)2004年美国临床肿瘤学会
Purpose The role of systemic chemotherapy in the management of pancreatic endocrine carcinoma (islet cell carcinoma; PEC) is an area of considerable controversy. Response rates ranging from 6% to 69% have been reported for streptozocin-based chemotherapy. We retrospectively studied 84 patients with locally advanced or metastatic PEC who had been treated with fluorouracil, doxorubicin, and streptozocin (FAS) to determine the objective response rate, duration of progression-free survival (PFS), and duration of overall survival (OS).Patients and Methods Eligible patients had histologic or cytologic confirmation of their tumor and measurable disease on computed tomography or magnetic resonance imaging scans. Response to treatment was evaluated in this study using the new international criteria proposed by the Response Evaluation Criteria in Solid Tumors Committee.Results Sixty-one of the patients were male and 23 were female, with a median age of 54 years (range, 24 to 78 years). The response rate (RR) to FAS was 39%, with a median response duration of 9.3 months. The 2-year PFS rate was 41%, and the 2-year OS rate was 74%. The extent of liver metastatic disease correlated with a worse PFS (P = .01 by log-rank test) and a worse OS (P < .0001 by log-rank test). Analyses showed that metastatic replacement of more than 75% of the liver and prior chemotherapy were independently associated with inferior PFS.Conclusion Patients with locally advanced or metastatic PEC who are treated with FAS may have a reasonable RR, and responders may experience longer PFS and OS. The volume of rnetastases in the liver is the most important predictor of outcome. (C) 2004 by American Society of Clinical Oncology