The optimal treatment strategy for neoadjuvant chemotherapy in elderly patients with pancreatic cancer (PC) remains unclear. Hence, this study was aimed at evaluating the safety and feasibility of neoadjuvant-modified FOLFIRINOX (mFOLFIRINOX) in elderly patients with PC. We retrospectively collected data from 62 patients who received neoadjuvant mFOLFIRINOX between May 2015 and October 2023 and comparatively analyzed the clinicopathological data and outcomes between the non-elderly group (age: <75 years) and elderly group (age: >75 years). The non-elderly and elderly groups comprised 39 and 23 patients, respectively. Although elevated levels of aspartate aminotransferase (p= 0.0173) and alanine aminotransferase (p= 0.0378) and nausea (p= 0.0177) were more frequent in the elderly group, the incidence of severe adverse events was similar between the groups. Intergroup differences in resection rate (p= 0.3381), postoperative severe complication rates (p= 0.2450), and postoperative hospital stay (p= 0.3496) were not significant. Furthermore, no significant intergroup differences were found in survival in either the whole or the resection cohorts. The perioperative and postoperative outcomes of elderly patients treated with neoadjuvant mFOLFIRINOX were comparable with those of non-elderly patients. Neoadjuvant mFOLFIRINOX should be considered a feasible option for elderly patients with PC.
胰腺癌老年患者新辅助化疗的最佳治疗策略尚不明确。本研究旨在评估改良FOLFIRINOX方案（mFOLFIRINOX）用于胰腺癌老年患者新辅助治疗的安全性与可行性。我们回顾性收集了2015年5月至2023年10月期间接受新辅助mFOLFIRINOX治疗的62例患者资料，对比分析了非老年组（年龄<75岁）与老年组（年龄≥75岁）的临床病理特征及治疗结局。非老年组与老年组分别纳入39例和23例患者。虽然老年组天冬氨酸氨基转移酶（p=0.0173）和丙氨酸氨基转移酶（p=0.0378）升高以及恶心症状（p=0.0177）的发生率更高，但两组严重不良事件发生率无显著差异。在手术切除率（p=0.3381）、术后严重并发症发生率（p=0.2450）及术后住院时间（p=0.3496）方面，组间差异均未达到统计学意义。此外，无论是整体队列还是手术切除亚组，两组患者的生存期均无显著差异。接受新辅助mFOLFIRINOX治疗的老年患者围手术期及术后结局与非老年患者相当。新辅助mFOLFIRINOX方案应被视为胰腺癌老年患者可行的治疗选择。
Safety and Feasibility of Neoadjuvant-Modified FOLFIRINOX in Elderly Patients with Pancreatic Cancer
肿瘤(癌症)患者之家