Back to Search
Start Over
Value of CT-Guided Percutaneous Irreversible Electroporation Added to FOLFIRINOX Chemotherapy in Locally Advanced Pancreatic Cancer: A Post Hoc Comparison.
- Source :
-
Journal of vascular and interventional radiology : JVIR [J Vasc Interv Radiol] 2020 Oct; Vol. 31 (10), pp. 1600-1608. Date of Electronic Publication: 2020 Aug 27. - Publication Year :
- 2020
-
Abstract
- Purpose: To compare survival after CT-guided percutaneous irreversible electroporation (IRE) and folinic acid, fluorouracil, irinotecan, and oxaliplatin (FOLFIRINOX) chemotherapy versus FOLFIRINOX only in patients with locally advanced pancreatic cancer (LAPC).<br />Materials and Methods: A post hoc comparison was performed of data derived from a prospective IRE-FOLFIRINOX cohort and a retrospective FOLFIRINOX-only cohort. All patients received a minimum of 3 cycles of FOLFIRINOX for LAPC and were considered eligible for CT-guided percutaneous IRE. Endpoints included overall survival (OS), local and distant progression-free survival, and time to progression (TTP) and were compared using stratified Kaplan-Meier analysis. Patients who received > 8 cycles of FOLFIRINOX before IRE and who had tumors > 6 cm in the FOLFIRINOX-only group were excluded.<br />Results: Of 103 patients with a diagnosis of LAPC, 52 were deemed eligible (n = 30 IRE-FOLFIRINOX and n = 22 FOLFIRINOX-only). Patients in the FOLFIRINOX-only arm had larger tumors (53 mm ± 19 vs 38 mm ± 7, P = .340), had more locoregional lymph node metastases (23% vs 7%, P = .622), and more often received radiotherapy (7 patients vs 2 patients, P = .027); all other baseline characteristics were comparable. Median OS was 17.0 months (range, 5-35 mo; SD = 6) for IRE-FOLFIRINOX versus 12.4 months (range, 3-22 mo; SD = 6) for FOLFIRINOX-only (P = .038). After sensitivity analyses, median OS was 17.2 months (range, 6-27 mo; SD = 6) versus 12.4 months (range, 7-32 mo; SD = 10) (P = .05). Median TTP was longer in the IRE-FOLFIRINOX group: 14.2 months (range, 5-25 mo; SD = 4) versus 5.2 months (range, 2-22; SD = 6) (P = .0001).<br />Conclusions: In patients with LAPC after FOLFIRINOX chemotherapy, CT-guided percutaneous IRE may improve OS and TTP. This study may facilitate the design of randomized controlled trials to compare survival after IRE-FOLRINOX versus FOLFIRINOX-only.<br /> (Copyright © 2020 SIR. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Antineoplastic Combined Chemotherapy Protocols adverse effects
Clinical Trials as Topic
Female
Fluorouracil administration & dosage
Fluorouracil adverse effects
Humans
Irinotecan administration & dosage
Irinotecan adverse effects
Leucovorin administration & dosage
Leucovorin adverse effects
Male
Middle Aged
Oxaliplatin administration & dosage
Oxaliplatin adverse effects
Pancreatic Neoplasms diagnostic imaging
Pancreatic Neoplasms mortality
Pancreatic Neoplasms pathology
Prospective Studies
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
Ablation Techniques adverse effects
Ablation Techniques mortality
Antineoplastic Combined Chemotherapy Protocols administration & dosage
Electroporation
Pancreatic Neoplasms therapy
Radiography, Interventional adverse effects
Radiography, Interventional mortality
Tomography, X-Ray Computed adverse effects
Tomography, X-Ray Computed mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1535-7732
- Volume :
- 31
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Journal of vascular and interventional radiology : JVIR
- Publication Type :
- Academic Journal
- Accession number :
- 32861569
- Full Text :
- https://doi.org/10.1016/j.jvir.2020.02.024