Administration of FOLFIRINOX for Advanced Pancreatic Cancer: Physician Practice Patterns During Early Use.

IF 2.8 4区 医学 Q2 ONCOLOGY
Joanna Gotfrit, Horia Marginean, Yoo-Joung Ko, Akmal Ghafoor, Petr Kavan, Haji Chalchal, Shahid Ahmed, Karen Mulder, Patricia Tang, Rachel Goodwin
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引用次数: 0

Abstract

Advanced pancreatic cancer results in high morbidity and mortality. The standard of care treatment in the advanced setting changed in 2011 with the introduction of FOLFIRINOX (FFX) chemotherapy. However, it was highly toxic with significant risk of complications. We assessed the practice patterns of medical oncologists across Canada.

Methods: We performed a retrospective study of consecutive patients with advanced pancreatic cancer treated with FFX at eight Canadian cancer centers. Demographic, treatment, and outcome data were collected and analyzed.

Results: The median age of the patients was 61 (range 24-80), 43% were female, 96% had an ECOG PS of 0 or 1, and 50% had three or more metastatic sites. The median follow-up time was 20.8 months (95%CI 18.6-24.9). Physicians started FFX at the standard dose 31% of the time. Physicians prescribed GCSF for primary prophylaxis most when giving standard-dose FFX (30% of the time) in comparison to reduced dose with or without the 5-FU bolus. Dose reductions occurred in 78.1% of patients, while dose delay occurred in 65.2% of patients.

Conclusions: Medical oncologists in Canada historically prescribed FFX to patients with advanced pancreatic cancer in a fashion that was not uniform, prior to the emergence of evidence for upfront dose reductions.

晚期胰腺癌的发病率和死亡率都很高。2011 年,随着 FOLFIRINOX(FFX)化疗的推出,晚期胰腺癌的标准治疗方法发生了改变。然而,该疗法毒性大,并发症风险高。我们对加拿大各地肿瘤内科医生的实践模式进行了评估:我们对加拿大八家癌症中心连续接受 FFX 治疗的晚期胰腺癌患者进行了回顾性研究。我们收集并分析了人口统计学、治疗和结果数据:患者的中位年龄为 61 岁(24-80 岁不等),43% 为女性,96% 的患者 ECOG PS 为 0 或 1,50% 的患者有三个或三个以上的转移部位。中位随访时间为 20.8 个月(95%CI 18.6-24.9)。31%的医生开始按标准剂量使用 FFX。在给予标准剂量 FFX 时(30% 的情况下),医生开具 GCSF 作为一级预防处方的比例最高,而在给予或不给予 5-FU 栓注的情况下,医生开具 GCSF 的比例较低。78.1%的患者减少了剂量,65.2%的患者延迟了剂量:加拿大的肿瘤内科医生在为晚期胰腺癌患者开具FFX处方时,在出现前期剂量减少的证据之前,处方方式并不统一。
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来源期刊
Current oncology
Current oncology ONCOLOGY-
CiteScore
3.30
自引率
7.70%
发文量
664
审稿时长
1 months
期刊介绍: Current Oncology is a peer-reviewed, Canadian-based and internationally respected journal. Current Oncology represents a multidisciplinary medium encompassing health care workers in the field of cancer therapy in Canada to report upon and to review progress in the management of this disease. We encourage submissions from all fields of cancer medicine, including radiation oncology, surgical oncology, medical oncology, pediatric oncology, pathology, and cancer rehabilitation and survivorship. Articles published in the journal typically contain information that is relevant directly to clinical oncology practice, and have clear potential for application to the current or future practice of cancer medicine.
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