The Clinical Efficacy And Safety Of Modified FOLFIRINOX Regimen In Advanced Pancreatic Cancer

Objective: To observe and analyze the clinical efficacy and safety of the modified FOLFIRINOX(mFOLFIRINOX)chemotherapy for advanced pancreatic cancer(APC).Methods: From January 2018 to September 2019,33 patients who were diagnosed as advanced pancreatic cancer clinically were collected from the First Affiliated Hospital of Wannan Medical College,including 18 cases of Local Advanced Pancreatic Cancer(LAPC)and 15 cases of metastatic pancreatic cancer(MPC)that were given mFOLFIRINOX chemotherapy(oxaliplatin 68mg/㎡,irinotecan 135mg/㎡,calcium folinate 400mg/㎡,fluorouracil 400mg/㎡,all intravenously administered;After that,continuous intravenous infusion of fluorouracil 2400mg/㎡,46 h,repeated every two weeks,2 courses as a cycle).To evaluate the efficacy of chemotherapy,before each course of chemotherapy,routinely check blood routine,liver and kidney function,serum tumor indicators and chest radiographs,electrocardiograms,etc.,reexamine the whole abdominal enhanced thin-layer CT every two cycles,and perform 3D image reconstruction if necessary,and we finally observed and analyzed the patients’ median overall survival time,median progression-free survival time,objective disease response rate,adverse reactions to chemotherapy,and surgical transformation.Results: A total of 25 patients received chemotherapy and completed evaluation finally,including 16 case of LAPC and 9 cases of MPC.The median chemotherapy time was 4 cycles,and the objective response rate was 36%.The median overall survival time of patients of LAPC was 14 months,and the median progression-free survival time was 11.5 months.The time of MPC was 11 months and 8 months respectively.In this study,12 cases(48%)of grade 3/4 adverse reactions occurred,7 cases in the LAPC group and 5 cases in the MPC group.Among them,there was 6 cases had neutropenia that was the most common,and the rest included anemia in 3 cases(3%),vomiting(4%)in 1 case,and so on.In addition,we found 4 patients(25%)completed conversion surgery in the 16 caes of LAPC,and the R0 resection rate was 75%.Conclusion: This modified FOLFIRINOX regimen had reliable clinical efficacy,tolerable adverse reactions,and high safety.It could become a clinical option for the treatment of advanced pancreatic cancer;The modified FOLFIRINOX regimen can enable LAPC patients to obtain surgical opportunities,and we will expand the sample size in the future.