FOLFIRINOX方案与GNP方案新辅助化疗对潜在可切除和局部晚期胰腺癌疗效比较的Meta分析  

Meta-analysis of FOLFIRINOX and GNP neoadjuvant chemotherapy in the treatment of patients with borderline resectable and locally advanced pancreatic adenocarcinoma

作　　者：何波 慕媛 徐阳 HE Bo;MU Yuan;XU Yang(Senior Department of Oncology,the Fifth Medical Center of PLA General Hospital,Beijing 100039,China)

机构地区：[1]解放军总医院第五医学中心肿瘤内科,北京100039 [2]武警特色医学中心医疗质量与安全管理科,300162

出　　处：《临床肿瘤学杂志》2024年第7期695-701,共7页Chinese Clinical Oncology

摘　　要：目的系统评价FOLFIRINOX方案与白蛋白结合型紫杉醇联合吉西他滨(GNP)方案新辅助化疗用于治疗潜在可切除/局部晚期胰腺癌(BRPC/LAPC)的有效性和安全性,为临床治疗提供依据。方法通过计算机检索多个中英文数据库,时间范围设定为从建库时间至2023年11月31日,收集FOLFIRINOX方案与GNP方案治疗BRPC/LAPC的有效性和安全性数据。采用Rev Man 5.3统计软件进行Meta分析。结果FOLFIRINOX组比GNP组的无进展生存期更长,但疾病进展发生率高于GNP组(P<0.05);两组在总生存、完全缓解、部分缓解、疾病稳定、客观缓解率、疾病控制率上的差异均无统计学意义(P>0.05)。FOLFIRINOX组的总体贫血、3~4级贫血、总体疲劳、3~4级疲劳发生率均低于GNP组(P<0.05);而3~4级腹泻、总体周围神经病变、3~4级周围神经病变发生率高于GNP组(P<0.05)。结论目前BRPC/LAPC的两种一线化疗方案比较,FOLFIRINOX方案比GNP方案的无进展生存期更长,但疾病进展发生率更高;FOLFIRINOX的毒副作用主要为贫血与疲劳,GNP的毒副作用主要为腹泻和周围神经病变。Objective To systematically evaluate the efficacy and safety of FOLFIRINOX and albumin-bound paclitaxel combined with gemcitabine(GNP)neoadjuvant chemotherapy in the treatment of patients with borderline resectable or locally advanced pancreatic cancer(BRPC/LAPC).Methods Multiple Chinese and English databases were searched by computer,and the time range was set to be from the database establishment time to November 31,2023.Data on the effectiveness and safety of FOLFIRINOX regimen and GNP regimens in the treatment of BRPC/LAPC were collected.Meta analysis was conducted using Rev Man 5.3 statistical software.Results The FOLFIRINOX group had a longer progression-free survival than the GNP group,but the incidence of disease progression was higher than that of the GNP group(P<0.05).There was no statistically significant difference between the two groups in overall survival,complete remission,partial remission,disease stability,objective remission rate,and disease control rate(P>0.05).FOLFIRINOX group had a lower incidences of overall anemia,grade 3-4 anemia,overall fatigue,and grade 3-4 fatigue compared to the GNP group(P<0.05).The incidences of grade 3-4 diarrhea,overall peripheral neuropathy,and grade 3-4 peripheral neuropathy were significantly higher in the GNP group than FOLFIRINOX group(P<0.05).Conclusion Compared with the current two first-line chemotherapy regimens for BRPC/LAPC,FOLFIRINOX regimen has a longer progression-free survival period than GNP regimen,but the incidence of disease progression is higher;The toxic side effects of FOLFIRINOX are mainly anemia and fatigue,while the toxic side effects of GNP are mainly diarrhea and peripheral neuropathy.

关 键 词：潜在可切除胰腺癌 局部晚期胰腺癌 FOLFIRINOX 白蛋白结合型紫杉醇 吉西他滨 GNP 

分 类 号：R735.9[医药卫生—肿瘤]