Outcomes with FOLFIRINOX for borderline resectable and locally unresectable pancreatic cancer

被引:158
作者
Boone, Brian A. [1 ]
Steve, Jennifer [1 ]
Krasinskas, Alyssa M. [2 ]
Zureikat, Amer H. [1 ]
Lembersky, Barry C. [3 ]
Gibson, Michael K. [3 ]
Stoller, Ronald G. [3 ]
Zeh, Herbert J. [1 ]
Bahary, Nathan [3 ]
机构
[1] Univ Pittsburgh, Dept Surg, Pittsburgh, PA USA
[2] Univ Pittsburgh, Dept Pathol, Pittsburgh, PA USA
[3] Univ Pittsburgh, Div Hematol Oncol, Pittsburgh, PA USA
基金
美国国家卫生研究院;
关键词
neoadjuvant treatment; borderline resectable; locally unresectable; pancreatic cancer: FOLFIRINOX; NEOADJUVANT THERAPY; PHASE-II; GEMCITABINE; ADENOCARCINOMA; CHEMOTHERAPY; CHEMORADIATION; OXALIPLATIN; RESECTION; IRINOTECAN; MANAGEMENT;
D O I
10.1002/jso.23392
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Trials examining FOLFIRINOX in metastatic pancreatic cancer demonstrate higher response rates compared to gemcitabine-based regimens. There is currently limited experience with neoadjuvant FOLFIRINOX in pancreatic cancer. Methods: Retrospective review of outcomes of patients with borderline resectable or locally unresectable pancreatic cancer who were recommended to undergo neoadjuvant treatment with FOLFIRINOX. Results: FOLFIRINOX was recommended for 25 patients with pancreatic cancer, 13 (52%) unresectable and 12 (48%) borderline resectable. Four patients (16%) refused treatment or were lost to follow-up. Twenty-one patients (84%) were treated with a median of 4.7 cycles. Six patients (29%) required dose reductions secondary to toxicity. Two patients (9%) were unable to tolerate treatment and three patients (14%) had disease progression on treatment. Seven patients (33%) underwent surgical resection following treatment with FOLFIRINOX alone, 2 (10%) of which were initially unresectable. Two patients underwent resection following FOLFIRINOX+stereotactic body radiation therapy (SBRT). The R0 resection rate for patients treated with FOLFIRINOX +/- SBRT was 33% (55% borderline resectable, 10% unresectable). A total of five patients (24%) demonstrated a significant pathologic response. Conclusions: FOLFIRINOX is a biologically active regimen in borderline resectable and locally unresectable pancreatic cancer with encouraging R0 resection and pathologic response rates. J. Surg. Oncol. 2013 108:236-241. (c) 2013 Wiley Periodicals, Inc.
引用
收藏
页码:236 / 241
页数:6
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