Comparison of Clinical Outcomes of Borderline Resectable Pancreatic Cancer According to the Neoadjuvant Chemo-Regimens: Gemcitabine versus FOLFIRINOX

Background/Aims: Although many studies have reported the promising effect of neoadjuvant treatment for borderline resectable pancreatic cancer (BRPC) to increase resectability, only a few studies have recommended the use of first-line chemotherapeutic agents as neoadjuvant treatment for BRPC. The cu...

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Published in:Gut and liver 2021-05, Vol.15 (3), p.466
Main Authors: Yoo Jin Choi, Yoonhyeong Byun, Jae Seung Kang, Hyeong Seok Kim, Youngmin Han, Hongbeom Kim, Wooil Kwon, Do-youn Oh, Woo Hyun Paik, Sang Hyub Lee, Ji Kon Ryu, Yong-tae Kim, Kyungbun Lee, Haeryoung Kim, Eui Kyu Chie, Jin-young Jang
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Language:Korean
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Neoadjuvant therapy
Pancreatic neoplasms
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container_issue 3
container_start_page 466
container_title Gut and liver
container_volume 15
creator Yoo Jin Choi
Yoonhyeong Byun
Jae Seung Kang
Hyeong Seok Kim
Youngmin Han
Hongbeom Kim
Wooil Kwon
Do-youn Oh
Woo Hyun Paik
Sang Hyub Lee
Ji Kon Ryu
Yong-tae Kim
Kyungbun Lee
Haeryoung Kim
Eui Kyu Chie
Jin-young Jang
description Background/Aims: Although many studies have reported the promising effect of neoadjuvant treatment for borderline resectable pancreatic cancer (BRPC) to increase resectability, only a few studies have recommended the use of first-line chemotherapeutic agents as neoadjuvant treatment for BRPC. The current study compared clinical outcomes between gemcitabine and FOLFIRINOX (5-fluorouracil, leucovorin, oxaliplatin, and irinotecan) in patients with BRPC. Methods: In this single-center retrospective study, 100 BRPC patients treated with neoadjuvant chemotherapy and resection from 2008 to 2018 were reviewed. Clinical outcomes included overall survival, resectability, and recurrence patterns after gemcitabine or FOLFIRINOX treatment. Results: For neoadjuvant chemotherapy, gemcitabine was administered to 34 patients and FOLFIRINOX to 66. Neoadjuvant radiotherapy was administered to 27 patients (79.4%) treated with gemcitabine and 19 (28.8%) treated with FOLFIRINOX (p
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fullrecord <record><control><sourceid>kiss</sourceid><recordid>TN_cdi_kiss_primary_3887688</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><kiss_id>3887688</kiss_id><sourcerecordid>3887688</sourcerecordid><originalsourceid>FETCH-kiss_primary_38876883</originalsourceid><addsrcrecordid>eNp9jM1OwkAUhWeBifjzBG7uCzSBNrajO5xYJTGUNC7cketwgYudGTJ3SuKD-L6WhDWrc3K-k2-kxtOnqszyXBfX6kZkP5mU07x6HKs_E9wBI0vwEDZgOvZssYOmTzY4ktP4EuKa4kAIWhKyCb87giV6GwkTWzBDpQgza4cn-y2kAGlHsKCA631_RJ_A7MiFrKUtO_LyDG_kLA-mk_VIUXqBuvmo5-180XzdqasNdkL357xVD_Xrp3nPflhkdYjsMP6uCq2rUuviMv0HRmVRig</addsrcrecordid><sourcetype>Publisher</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Comparison of Clinical Outcomes of Borderline Resectable Pancreatic Cancer According to the Neoadjuvant Chemo-Regimens: Gemcitabine versus FOLFIRINOX</title><source>PubMed Central</source><creator>Yoo Jin Choi ; Yoonhyeong Byun ; Jae Seung Kang ; Hyeong Seok Kim ; Youngmin Han ; Hongbeom Kim ; Wooil Kwon ; Do-youn Oh ; Woo Hyun Paik ; Sang Hyub Lee ; Ji Kon Ryu ; Yong-tae Kim ; Kyungbun Lee ; Haeryoung Kim ; Eui Kyu Chie ; Jin-young Jang</creator><creatorcontrib>Yoo Jin Choi ; Yoonhyeong Byun ; Jae Seung Kang ; Hyeong Seok Kim ; Youngmin Han ; Hongbeom Kim ; Wooil Kwon ; Do-youn Oh ; Woo Hyun Paik ; Sang Hyub Lee ; Ji Kon Ryu ; Yong-tae Kim ; Kyungbun Lee ; Haeryoung Kim ; Eui Kyu Chie ; Jin-young Jang</creatorcontrib><description>Background/Aims: Although many studies have reported the promising effect of neoadjuvant treatment for borderline resectable pancreatic cancer (BRPC) to increase resectability, only a few studies have recommended the use of first-line chemotherapeutic agents as neoadjuvant treatment for BRPC. The current study compared clinical outcomes between gemcitabine and FOLFIRINOX (5-fluorouracil, leucovorin, oxaliplatin, and irinotecan) in patients with BRPC. Methods: In this single-center retrospective study, 100 BRPC patients treated with neoadjuvant chemotherapy and resection from 2008 to 2018 were reviewed. Clinical outcomes included overall survival, resectability, and recurrence patterns after gemcitabine or FOLFIRINOX treatment. Results: For neoadjuvant chemotherapy, gemcitabine was administered to 34 patients and FOLFIRINOX to 66. Neoadjuvant radiotherapy was administered to 27 patients (79.4%) treated with gemcitabine and 19 (28.8%) treated with FOLFIRINOX (p&lt;0.001). The 2- and 5-year survival rates (YSRs) were significantly higher after FOLFIRINOX (2YSR, 72.2%; 5YSR, 46.0%) than after gemcitabine (2YSR, 58.4%; 5YSR, 19.1%; p=0.041). The margin negative rate was comparable (gemcitabine, 94.1%; FOLFIRINOX, 92.4%; p=0.753), and the tumor size change in percentage showed only a marginal difference (gemcitabine, 20.5%; FOLFIRINOX, 29.0%; p=0.069). Notably, the metastatic recurrence rate was significantly lower in the FOLFIRINOX group (n=20, 52.6%) than in the gemcitabine group (n=22, 78.6%; p=0.001). The rate of adverse events after chemotherapy was significantly higher with FOLFIRINOX than with gemcitabine (43.9%, 20.6%, respectively; p=0.037). Conclusions: FOLFIRINOX provided more clinical and oncological benefit than gemcitabine, with significantly higher overall survival and lower cumulative recurrence rates in BRPC. However, since FOLFIRINOX causes more adverse effects, the regimen should be individualized based on patient’s general condition and clinical status. (Gut Liver 2021;15:466-475)</description><identifier>ISSN: 1976-2283</identifier><language>kor</language><publisher>대한소화기학회</publisher><subject>Neoadjuvant therapy ; Pancreatic neoplasms</subject><ispartof>Gut and liver, 2021-05, Vol.15 (3), p.466</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784</link.rule.ids></links><search><creatorcontrib>Yoo Jin Choi</creatorcontrib><creatorcontrib>Yoonhyeong Byun</creatorcontrib><creatorcontrib>Jae Seung Kang</creatorcontrib><creatorcontrib>Hyeong Seok Kim</creatorcontrib><creatorcontrib>Youngmin Han</creatorcontrib><creatorcontrib>Hongbeom Kim</creatorcontrib><creatorcontrib>Wooil Kwon</creatorcontrib><creatorcontrib>Do-youn Oh</creatorcontrib><creatorcontrib>Woo Hyun Paik</creatorcontrib><creatorcontrib>Sang Hyub Lee</creatorcontrib><creatorcontrib>Ji Kon Ryu</creatorcontrib><creatorcontrib>Yong-tae Kim</creatorcontrib><creatorcontrib>Kyungbun Lee</creatorcontrib><creatorcontrib>Haeryoung Kim</creatorcontrib><creatorcontrib>Eui Kyu Chie</creatorcontrib><creatorcontrib>Jin-young Jang</creatorcontrib><title>Comparison of Clinical Outcomes of Borderline Resectable Pancreatic Cancer According to the Neoadjuvant Chemo-Regimens: Gemcitabine versus FOLFIRINOX</title><title>Gut and liver</title><addtitle>Gut and Liver</addtitle><description>Background/Aims: Although many studies have reported the promising effect of neoadjuvant treatment for borderline resectable pancreatic cancer (BRPC) to increase resectability, only a few studies have recommended the use of first-line chemotherapeutic agents as neoadjuvant treatment for BRPC. The current study compared clinical outcomes between gemcitabine and FOLFIRINOX (5-fluorouracil, leucovorin, oxaliplatin, and irinotecan) in patients with BRPC. Methods: In this single-center retrospective study, 100 BRPC patients treated with neoadjuvant chemotherapy and resection from 2008 to 2018 were reviewed. Clinical outcomes included overall survival, resectability, and recurrence patterns after gemcitabine or FOLFIRINOX treatment. Results: For neoadjuvant chemotherapy, gemcitabine was administered to 34 patients and FOLFIRINOX to 66. Neoadjuvant radiotherapy was administered to 27 patients (79.4%) treated with gemcitabine and 19 (28.8%) treated with FOLFIRINOX (p&lt;0.001). The 2- and 5-year survival rates (YSRs) were significantly higher after FOLFIRINOX (2YSR, 72.2%; 5YSR, 46.0%) than after gemcitabine (2YSR, 58.4%; 5YSR, 19.1%; p=0.041). The margin negative rate was comparable (gemcitabine, 94.1%; FOLFIRINOX, 92.4%; p=0.753), and the tumor size change in percentage showed only a marginal difference (gemcitabine, 20.5%; FOLFIRINOX, 29.0%; p=0.069). Notably, the metastatic recurrence rate was significantly lower in the FOLFIRINOX group (n=20, 52.6%) than in the gemcitabine group (n=22, 78.6%; p=0.001). The rate of adverse events after chemotherapy was significantly higher with FOLFIRINOX than with gemcitabine (43.9%, 20.6%, respectively; p=0.037). Conclusions: FOLFIRINOX provided more clinical and oncological benefit than gemcitabine, with significantly higher overall survival and lower cumulative recurrence rates in BRPC. However, since FOLFIRINOX causes more adverse effects, the regimen should be individualized based on patient’s general condition and clinical status. 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The current study compared clinical outcomes between gemcitabine and FOLFIRINOX (5-fluorouracil, leucovorin, oxaliplatin, and irinotecan) in patients with BRPC. Methods: In this single-center retrospective study, 100 BRPC patients treated with neoadjuvant chemotherapy and resection from 2008 to 2018 were reviewed. Clinical outcomes included overall survival, resectability, and recurrence patterns after gemcitabine or FOLFIRINOX treatment. Results: For neoadjuvant chemotherapy, gemcitabine was administered to 34 patients and FOLFIRINOX to 66. Neoadjuvant radiotherapy was administered to 27 patients (79.4%) treated with gemcitabine and 19 (28.8%) treated with FOLFIRINOX (p&lt;0.001). The 2- and 5-year survival rates (YSRs) were significantly higher after FOLFIRINOX (2YSR, 72.2%; 5YSR, 46.0%) than after gemcitabine (2YSR, 58.4%; 5YSR, 19.1%; p=0.041). The margin negative rate was comparable (gemcitabine, 94.1%; FOLFIRINOX, 92.4%; p=0.753), and the tumor size change in percentage showed only a marginal difference (gemcitabine, 20.5%; FOLFIRINOX, 29.0%; p=0.069). Notably, the metastatic recurrence rate was significantly lower in the FOLFIRINOX group (n=20, 52.6%) than in the gemcitabine group (n=22, 78.6%; p=0.001). The rate of adverse events after chemotherapy was significantly higher with FOLFIRINOX than with gemcitabine (43.9%, 20.6%, respectively; p=0.037). Conclusions: FOLFIRINOX provided more clinical and oncological benefit than gemcitabine, with significantly higher overall survival and lower cumulative recurrence rates in BRPC. However, since FOLFIRINOX causes more adverse effects, the regimen should be individualized based on patient’s general condition and clinical status. (Gut Liver 2021;15:466-475)</abstract><pub>대한소화기학회</pub><tpages>10</tpages></addata></record>
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Pancreatic neoplasms
title Comparison of Clinical Outcomes of Borderline Resectable Pancreatic Cancer According to the Neoadjuvant Chemo-Regimens: Gemcitabine versus FOLFIRINOX
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