Full dose neoadjuvant FOLFIRINOX is associated with prolonged survival in patients with locally advanced pancreatic adenocarcinoma

摘要: Abstract Background The efficacy of FOLFIRINOX for metastatic pancreatic cancer has led to its use in patients with earlier stages disease. This study retrospectively analyzed a cohort locally-advanced (LAPC) treated FOLFIRINOX. Methods Between 2008 and 2013, 51 treatment-naive LAPC at single institution received first-line neoadjuvant intent, the full dose as described PRODIGE 4/ACCORD 11 study. Combined chemoradiation was administered those who remained unresectable after maximum response chemotherapy. primary outcome measure overall survival (OS), secondary outcomes were progression-free (PFS) margin-negative (R0) resection rate, toxicity profile. Results A total 429 cycles given median 8 (range 2–29) per patient; 66% dose. After chemotherapy, 27 (53%) chemoradiation. OS 35.4 months (95% CI 25.8–45). Ten (4 borderline resectable 6 unresectable) had successful R0 resections; resections significantly longer than did not (3-year rate 67% versus 21%, log rank p = 0.042). Increasing number full-dose associated increased survival. profile similar previous reports this regimen. Conclusions is feasible therapy LAPC. Although only 20%, almost 3 years appears promising. Dose intensity duration study, arguing against attenuated versions