关键词: 晚期胰腺癌, FOLFIRINOX方案, AG方案, 多中心研究

Abstract: Objective We conducted a multicenter observational study comparing the FOLFIRINOX regimen and the AG regimen as the first-line treatment in advanced pancreatic cancer, and summarized experience to guide clinical practice. Methods Participants of this study were retrospectively recruited from the Guangdong Provincial People′s Hospital, Sun Yat-sen Memorial Hospital of Sun Yat-Sen University, the First Affiliated Hospital of Sun Yat-sen University, the First Affiliated Hospital of Guangdong Pharmaceutical University, and the Zhongshan People′s Hospital between January 2016 and June 2020. All these patients were diagnosed with advanced pancreatic cancer. They all received FOLFIRINOX regimen or AG regimen as the first-line treatment, and all had complete survival data. The last follow-up time was October 31, 2020. The primary endpoint was OS. The survival analysis was performed by the Kaplan-Meier method. A two-tailed P-value of less than 0.05 was considered as statistically significant. Results The five centers included a total of 62 patients who met the inclusion and exclusion criteria. According to the first-line chemotherapy regimen, 26 patients were included in the FOLFIRINOX （FFX） regimen group, and the remaining 36 patients were included in the AG regimen group. The median OS of the FFX regimen group and the AG regimen group were 13 months and 11 months, respectively （P=0.202）. And the median PFS were 10 months and 11 months the FFX regimen group and the AG regimen group, respectively（P=0.132）. There was no statistically significant difference in OS and PFS between the two groups. There were 5 patients receiving FFX regimen as the first-line treatment but AG regimen as the second-line, and 6 patients receiving AG regimen as the first-line treatment but FFX regimen as the second-line treatment. A total of 11 patients were included in the analysis. The median OS was 13 months and 11 months, respectively. When the CA199 level increased abnormally, especially 59 times higher than the normal value, the median OS of the AG group （10.21 months） was numerically longer than the FFX group （3.5 months）. Due to the lack of data, statistical analysis of Objective efficiency and adverse reactions was abandoned. Conclusion There were no significant differences in the efficacy between the FOLFIRINOX regimen group and the AG regimen group as the first-line treatment for advanced pancreatic cancer. It seemed that the order of medication didn′t affect the efficacy. The use of CA199 level to predict the efficacy of different treatments may be helpful, and it deserves further exploration.

Key words: advanced pancreatic cancer, FOLFIRINOX regimen, AG regimen, multicenter observational study