胰腺癌FOLFIRINOX方案化疗单中心经验报道  

FOLFIRINOX in treatment of pancreatic cancer:a single-institutional experience

作　　者：司爽[1] 刘立国[1] 周瑞泉 谭海东[1] 孙永亮[1] 刘笑雷[1] 徐力[1] 周文颖[1] 黄笳 杨志英[1] Si Shuang;Liu Liguo;Zhou Ruiquan;Tan Haidong;Sun Yongliang;Liu Xiaolei;Xu Li;Zhou Wenying;Huang Jia;Yang Zhiying(Department of General Surgery,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院普通外科,北京100029

出　　处：《中华肝胆外科杂志》2020年第9期651-655,共5页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的探讨氟尿嘧啶+伊立替康+亚叶酸钙+奥沙利铂(FOLFORINOX)化疗方案在胰腺癌治疗中的有效性和安全性。方法回顾分析2016年7月至2019年12月中日友好医院普通外科采用FOLFIRINOX化疗方案治疗的31例胰腺癌患者资料,其中男性20例,女性11例,年龄范围29~80岁,平均56.9岁。31例患者中术前新辅助化疗12例,转移性胰腺癌10例,根治术后化疗9例(7例为二线化疗,2例为辅助化疗)。化疗后评估临床疗效与不良反应情况。结果31例患者中接受改良FOLFIRINOX方案8例,标准FOLFIRINOX方案23例,其中有10例(43.5%)因化疗不良反应减量为改良方案。新辅助化疗后疗效评价:部分缓解5例,疾病稳定3例,疾病进展4例,疾病控制率66.7%(8/12),疼痛症状缓解10例,5例转化为手术切除。转移性胰腺癌患者疗效评价:部分缓解6例,疾病稳定1例,疾病进展3例。达到疾病控制7例。疼痛症状缓解8例。1例转化为手术切除。二线化疗疗效评价:部分缓解2例,疾病进展5例。另2例术后辅助化疗患者均未见肿瘤复发、转移。发生3级以上不良反应包括中性粒细胞减少12例(38.7%),白细胞减少7例(22.6%),血小板减少1例(3.2%)。结论FOLFIRINOX化疗方案的疾病控制率较好,不良反应可控,通过平衡其有效性及安全性,可使胰腺癌患者得到更多的获益。Objective To review the clinical efficacy and safety of the FOLFIRINOX(oxaliplatin,irinotecan,leucovorin,fluorouracil)regimen in treatment of pancreatic cancer.Methods The clinical data of 31 patients with pancreatic cancer who were treated with the FOLFIRINOX regimen from July 2016 to December 2019 at the Department of General Surgery,China-Japan Friendship Hospital were retrospectively analyzed.For the 20 males and 11 females who were enrolled into this study,their age ranged from 29 to 80 years(mean 56.9 years).The FOLFIRINOX regimen was used as neoadjuvant therapy in 12 patients,postoperative therapy in 10 patients with liver-metastases,and postoperative adjuvant therapy in 9 patients(as second-line chemotherapy in 7 patients and as first-line chemotherapy in 2 patients).The clinical efficacy and adverse reactions of chemotherapy were evaluated.Results In this study,8 patients received the modified FOLFIRINOX regimen.Of the remaining 23 patients who received the standard FOLFIRINOX regimen,10(43.3%)were converted to the modified regimen because of adverse events.On clinical efficacy evaluation after neoadjuvant therapy:5 patients achieved partial remission(PR),3 stable disease(SD)and 4 progression disease(PD).The disease control rate(DCR)was 66.7%(8/12).For 10 patients got remission of abdominal pain,5 patients underwent surgical resection.For the 10 patients with liver-metastases,6 achieved PR,1 SD,3 PD.For 7 patients got disease control.For 8 patients had remission of abdominal pain,1 patient underwent surgical resection.For the 7 patients who received second-line chemotherapy,2 achieved PR and 5 PD.No tumor recurrence or metastases were found in the two patients after the first-line chemotherapy.Adverse events above grade three in all the patients included neutropenia in 12 patients(38.7%),leukopenia in 7 patients(22.6%)and thrombocytopenia in 1 patient(3.2%).Conclusions The FOLFIRINOX regimen was efficacious with a high DCR rate and controllable adverse events.Balancing its efficacy and safety showed this

关 键 词：胰腺肿瘤 新辅助化疗 不良反应 

分 类 号：R735.9[医药卫生—肿瘤]