吉西他滨/白蛋白结合型紫杉醇与FOLFIRINOX用于晚期胰腺癌姑息性一线治疗:倾向评分分析解读  

Study Interpretation: Gemcitabine/nab-Paclitaxel Versus FOLFIRINOX for Palliative First-line Treatment of Advanced Pancreatic Cancer: A Propensity Score Analysis

作　　者：张娜 王锦毓 应杰儿 ZHANG Na;WANG Jin-yu;YING Jie-er(The Cancer Hospital of the University of Chinese Academy of Sciences(Zhejiang Cancer Hospital),Institute of Basic Medicine and Cancer(IBMC),Chinese A cademy of Sciences,Hangzhou 310022,China)

机构地区：[1]中国科学院大学附属肿瘤医院(浙江省肿瘤医院),中国科学院基础医学与肿瘤研究所,浙江杭州310022

出　　处：《肿瘤学杂志》2022年第2期155-161,共7页Journal of Chinese Oncology

摘　　要：通过比较真实世界接受FOLFIRINOX(亚叶酸+奥沙利铂+伊立替康+氟尿嘧啶)或GN(吉西他滨+白蛋白结合型紫杉醇)方案治疗的晚期胰腺癌患者的临床结果来指导临床实践。该研究为三中心的回顾性队列研究,采用倾向评分逆概率加权法调整研究组之间的混杂因素。FOLFIRINOX组和GN组的主要研究终点(OS)和次要研究终点(PFS、DCR、ORR)在倾向评分矫正前后差异均无统计学意义。FOLFIRINOX组粒缺性发热和腹泻患者发生比例显著高于GN组,而出现中性粒细胞减少、周围神经病变、胆管炎和疲劳症状的比例两组相近。目前尚不能证明FOLFIRINOX方案和GN方案的疗效差异,在临床实践过程中应考虑患者临床特征选择合适的治疗方案。The study was published in May 2021 in Eur J Cancer written by Riedl JM, Posch F, Horvath L, et al, which compared the clinical outcomes of patients with advanced pancreatic cancer who received FOLFIRINOX(leucovorin+oxaliplatin+ irinotecan+fluorouracil) or GN(gemcitabine/nab-paclitaxel). This was a three-center retrospective cohort study in which propensity score inverse probability weighting was used to adjust for confounding factors in study groups. There was no statistically significant difference in primary end points(OS) and secondary end points(PFS, DCR, ORR) between the FOLFIRINOX and GN groups before and after adjustment. The incidence rates of febrile neutropenia and diarrhea were higher in FOLFIRINOX group, while the rates of any neutropenia, any neuropathy,cholangitis and fatigue symptoms were similar between two groups. There was no evidence of superiority between FOLFIRINOX and GN. The study suggests that clinical characteristics of patients with advanced pancreatic cancer should be considered for choosing appropriate protocols in clinical practice.

关 键 词：胰腺导管癌 FOLFIRINOX 吉西他滨/白蛋白结合型紫杉醇 一线治疗 倾向评分 

分 类 号：R735.9[医药卫生—肿瘤]