在晚期胆道癌症中对二线化疗方案的比较:系统性审查,元分析和基于人群的队列研究
Galam Leem1,2, Kihun Kim3, Jeehoon Kim1,2
1Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
International journal of surgery (London, England)
|September 5, 2025
概括
作为晚期胆道癌的二线治疗方法,FOLFIRINOX显示出有前途的结果,与其他疗法相比,其存活率有所改善. 这种化疗组合具有可控的副作用,支持其在BTC治疗中的潜在用途.
科学领域:
- 癌症学
- 胃肠病学
- 临床药理学
背景情况:
- 胆道癌 (BTC) 是一种侵袭性癌症,其治疗选择有限.
- 在BTC的第一线化疗失败需要有效的第二线策略.
- 需要进一步阐明FOLFIRINOX在二线BTC治疗中的作用.
研究的目的:
- 评估FOLFIRINOX作为高级BTC的二线治疗的疗效和安全性.
- 通过元分析将FOLFIRINOX的结果与现有的二线治疗方案 (FOLFIRI,FOLFOX,nal- IRI/ FL) 进行比较.
主要方法:
- 54名用FOLFIRINOX治疗的晚期BTC患者的回顾性分析.
- 对21项二线BTC治疗研究的系统审查和元分析.
- 评估无进展生存率 (PFS),总生存率 (OS),客观反应率 (ORR),疾病控制率 (DCR) 和安全性.
主要成果:
- 在队列中,PFS的中位数为2. 7个月,OS为8. 9个月.
- 分析显示FOLFIRINOX的总体PFS为4. 15个月,OS为8. 91个月.
- 在40. 7%的患者中发生3-5级中性质减退,毒性可控,停药率低.
结论:
- 与目前的高级BTC二线疗法相比,FOLFIRINOX在数量上表现出更好的结果.
- 可以控制的毒性支持FOLFIRINOX作为潜在的二线治疗选择.
- 需要进一步的前性研究来验证这些发现并完善患者选择.
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