%0 Journal Article
%T A retrospective study of neoadjuvant FOLFIRINOX in unresectable or borderline-resectable locally advanced pancreatic adenocarcinoma
%A Peter J Hosein
%A Jessica Macintyre
%A Carolina Kawamura
%A Jennifer Cudris Maldonado
%A Vinicius Ernani
%A Arturo Loaiza-Bonilla
%A Govindarajan Narayanan
%A Afonso Ribeiro
%A Lorraine Portelance
%A Jaime R Merchan
%A Joe U Levi
%A Caio M Rocha Lima
%J BMC Cancer
%D 2012
%I BioMed Central
%R 10.1186/1471-2407-12-199
%X In this retrospective series, we included patients with unresectable LAPC who received neoadjuvant FOLFIRINOX with growth factor support. The primary analysis endpoint was R0 resection rate.Eighteen treatment-na£¿ve patients with unresectable or borderline resectable LAPC were treated with neoadjuvant FOLFIRINOX. The median age was 57.5£¿years and all had ECOG PS of 0 or 1. Eleven (61£¿%) had tumors in the head of the pancreas and 9 (50£¿%) had biliary stents placed prior to chemotherapy. A total of 146 cycles were administered with a median of 8 cycles (range 3-17) per patient. At maximum response or tolerability, 7 (39£¿%) were converted to resectability by radiological criteria; 5 had R0 resections, 1 had an R1 resection, and 1 had unresectable disease. Among the 11 patients who remained unresectable after FOLFIRINOX, 3 went on to have R0 resections after combined chemoradiotherapy, giving an overall R0 resection rate of 44£¿% (95£¿% CI 22¨C69£¿%). After a median follow-up of 13.4£¿months, the 1-year progression-free survival was 83£¿% (95£¿% CI 59-96£¿%) and the 1-year overall survival was 100£¿% (95£¿% CI 85-100£¿%). Grade 3/4 chemotherapy-related toxicities were neutropenia (22£¿%), neutropenic fever (17£¿%), thrombocytopenia (11£¿%), fatigue (11£¿%), and diarrhea (11£¿%). Common grade 1/2 toxicities were neutropenia (33£¿%), anemia (72£¿%), thrombocytopenia (44£¿%), fatigue (78£¿%), nausea (50£¿%), diarrhea (33£¿%) and neuropathy (33£¿%).FOLFIRINOX followed by chemoradiotherapy is feasible as neoadjuvant therapy in patients with unresectable LAPC. The R0 resection rate of 44£¿% in this population is promising. Further studies are warranted.
%K Pancreatic ductal carcinoma
%K neoadjuvant therapy
%K surgery
%K radiation therapy
%U http://www.biomedcentral.com/1471-2407/12/199/abstract