Abstract:

INTRODUCTION: Pancreatic cancer is among the cancers with the worst prognosis and therefore adjuvant treatment is very important for reducing mortality. The aim of this study is to compare the gold standard mFolfirinox regimen with other treatment regimens in the adjuvant treatment of pancreatic cancer in real-world practice. METHODS: Patients who underwent pancreatic cancer resection and received at least one dose of adjuvant chemotherapy were included in the study as two groups, mFolfirinox and Others (at a ratio of 1: 2). The primary endpoint was disease-free survival (DFS). Secondary endpoints were determined as overall survival (OS), predictive factors, and safety. RESULTS: Data of 166 patients were collected from 5 oncology centers. With a median follow-up of 30.3 months (24.6 - 35.9), the estimated median DFS was detected 17.9 months (95% CI, 10.3 - 25.6) in the mFolfirinox group and 12.5 months (95% CI, 9.7 - 15.3) in the others group (p = 0.088). The estimated median OS was 30.7 months (95% CI, 15.7 - 45.7) in the mFolfirinox group and 22 months (95% CI, 16 - 27.9) in the others group (p = 0.464). Better ECOG performance status, tumor location outside the head and ampulla, stage 1 and 2B, not receiving adjuvant chemoradiotherapy (CRT), and perineural invasion provide a disease-free survival advantage in favor of mFolfirinox. DISCUSSION AND CONCLUSION: In the adjuvant treatment of resected pancreatic cancer, the mFolfirinox regimen provided a statistically insignificant, but clinically significant DFS and OS benefit.

Keywords: