| ObjectiveFolfirinox regimen treating patients with advanced pancreatic cancer has shown high response rate and increased survival but with a significant toxicity. Duo to the strong toxicity, Folfirinox has a limited application in China. Herein, we developed a modified Folfirinox (mFolfirinox) regimen by dose attenuation since 2014. This report presented our work on mFolfirinox in locally advanced pancreatic cancer (LAPC) and metastatic pancreatic cancer (MPC).MethodsBetween April 2014 and October 2015,35 patients with LAPC (n=18) and MPC (n=17) were treated with mFolfirinox regimen (irinotecan 135mg/m2, oxaliplatin 68mg/m2,5-FU 2400mg/m2, no bolus of 5-FU, leucovorin 400mg/m2) in our institution. The primary end point was progression free survival. The second end points were overall survival, objective response rate, adverse effects,surgical resection rate for LAPC.ResultsAmong 35 patients,6 patients (17.1%), who dropped out and received less than 2 cycles, were excluded for response analysis. Among the other 29 patients,9 patients had grade 3 or 4 adverse effects (31.0%). No patients ceased treatment due to adverse effects except for 1 patient who has Hepatic vein occlusion syndrome (HVOD) after chemotherapy quit for further chemotherapy. The 29 patients received 5(2-13) cycles were evaluated by efficacy and found PR in 16 cases (55.2%), SD in 10 cases (34.5%), PD in 3 cases (10.3%). Response rate (RR) was 55.2%. And median overall survival (mOS) was 12 months.6 months and 1 year survival were 92.9% and 40.4%.10 (71.4%) patients with LAPC accomplished surgery after neoadjuvant treatment without perioperative complication and death, and R0 resection rate reached 70%.ConclusionsOur initial experience showed the newly developed mFolfinox regimen is well-tolerated in Chinese population with high treatment efficacy on patients with LAPC and MPC. Further investigation of efficacy and adverse effects on more advanced pancreatic cancer patients is necessary. |
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