CHICAGO-Chemotherapy ea Neoadjuvant e ke ke ea tsamaisana le opereishene ea pele bakeng sa ho phela bakeng sa mofets'e oa pancreatic, ho bonts'a liteko tse nyane tse sa reroang.
Ka mokhoa o sa lebelloang, bakuli ba ileng ba buuoa ka lekhetlo la pele ba ne ba phela nako e fetang selemo ho feta ba ileng ba fumana thupelo e khutšoanyane ea chemotherapy ea FOLFIRINOX pele ba buuoa.Sephetho sena se makatsa ka ho khetheha ho latela hore phekolo ea neoadjuvant e ne e amahanngoa le tekanyo e phahameng ea likhahla tse mpe tsa ho buoa (R0) le hore bakuli ba bangata sehlopheng sa phekolo ba fihletse boemo ba node-negative.
"Tlhaloso e eketsehileng e ka hlalosa hamolemo phello ea nako e telele ea ntlafatso ea R0 le N0 sehlopheng sa neoadjuvant," ho boletse Knut Jorgen Laborie, MD, Univesithi ea Oslo, Norway, American Society of Clinical Oncology.ASCO) seboka."Liphetho ha li tšehetse tšebeliso ea neoadjuvant FOLFIRINOX e le kalafo e tloaelehileng bakeng sa mofets'e oa pancreatic."
Sephetho sena se ile sa makatsa Andrew H. Ko, MD, oa Univesithi ea California, San Francisco, ea memetsoeng moqoqong, 'me o ile a lumela hore ha ba tšehetse neoadjuvant FOLFIRINOX e le mokhoa o mong oa ho buuoa ka pele.Empa hape ha ba qhelele ka thoko monyetla ona.Ka lebaka la thahasello e itseng thutong, ha ho khonehe ho etsa polelo e hlakileng mabapi le boemo ba nako e tlang ba FOLFIRINOX neoadjuvant.
Ko o hlokometse hore ke halofo feela ea bakuli ba qetileng mekhahlelo e mene ea chemotherapy ea neoadjuvant, "e leng tlase haholo ho feta seo ke neng ke se lebelletse bakeng sa sehlopha sena sa bakuli, bao mekhoa e mene ea kalafo e seng thata haholo ho bona ......ea bobeli, ke hobane'ng ha liphello tse ntle tsa ho buoa le tsa pathological [R0, N0 boemo] li lebisa ho mokhoa o lebisang liphellong tse mpe ho sehlopha sa neoadjuvant?utloisisa sesosa 'me qetellong u fetohele mekhoeng e thehiloeng ho gemcitabine."
"Ka hona, re hlile re ke ke ra fihlela liqeto tse tiileng ho tsoa thutong ena mabapi le phello e tobileng ea FOLFIRINOX ea perioperative liphellong tsa ho pholoha ... FOLFIRINOX e ntse e le teng, 'me liphuputso tse' maloa tse tsoelang pele li tla fana ka leseli mabapi le bokhoni ba eona ba ho buuoa ka mokhoa o tsosolositsoeng."Mafu.”
Laborie o hlokometse hore opereishene e kopantsoeng le kalafo e sebetsang ea systemic e fana ka litholoana tse ntle ka ho fetisisa bakeng sa mofetše oa pancreatic.Ka tloaelo, maemo a tlhokomelo a kenyelletsa opereishene ea pele le chemotherapy ea adjuvant.Leha ho le joalo, phekolo ea neoadjuvant e lateloang ke opereishene le chemotherapy ea adjuvant e se e qalile ho tsebahala har'a litsebi tse ngata tsa oncology.
Phekolo ea Neoadjuvant e fana ka melemo e mengata e ka bang teng: taolo ea pele ea lefu la systemic, phano e ntlafalitsoeng ea chemotherapy, le liphetho tse ntlafalitsoeng tsa histopathological (R0, N0), Laborie a tsoela pele.Leha ho le joalo, ho fihlela joale, ha ho na teko e sa reroang e bontšitseng ka ho hlaka molemo oa ho pholoha oa neoadjuvant chemotherapy.
Ho sebetsana le khaello ea data litekong tse sa reroang, bafuputsi ba tsoang litsing tse 12 tsa Norway, Sweden, Denmark le Finland ba ile ba hira bakuli ba nang le mofetše oa hlooho ea pancreatic.Bakuli ba ileng ba etsoa opereishene ea pele ba ile ba fumana li-cycle tse 12 tsa adjuvant-modified FOLFIRINOX (mFOLFIRINOX).Bakuli ba fumanang phekolo ea neoadjuvant ba ile ba fumana li-cycle tsa 4 tsa FOLFIRINOX tse lateloa ke ho pheta-pheta le ho buuoa, ho lateloa ke li-cycle tsa 8 tsa adjuvant mFOLFIRINOX.Qetello e ka sehloohong e ne e le ho phela ka kakaretso (OS), 'me thuto e ile ea fuoa matla a ho bontša ntlafatso ea ho pholoha ha likhoeli tsa 18 ho tloha 50% ka ho buuoa ka pele ho 70% ka neoadjuvant FOLFIRINOX.
Lintlha li ne li kenyelletsa bakuli ba 140 ba nang le maemo a ECOG 0 kapa 1. Sehlopheng sa pele sa ho buuoa, 56 ea bakuli ba 63 (89%) ba ile ba etsoa opereishene 'me 47 (75%) ba qala chemotherapy ea adjuvant.Ho bakuli ba 77 ba abetsoeng kalafo ea neoadjuvant, 64 (83%) ba ile ba qala kalafo, 40 (52%) ba qetile kalafo, 63 (82%) ba ile ba hlajoa, 'me ba 51 (66%) ba ile ba qala kalafo ea adjuvant.
Liketsahalo tse mpe tsa Kereiti ≥3 (AEs) li ile tsa bonoa ho 55.6% ea bakuli ba fumanang chemotherapy ea neoadjuvant, haholo-holo letšollo, ho nyekeloa ke pelo le ho hlatsa, le neutropenia.Nakong ea chemotherapy ea adjuvant, hoo e ka bang 40% ea bakuli sehlopheng se seng le se seng sa phekolo ba ile ba ba le sehlopha sa ≥3 AEs.
Ha ho hlahlojoa sepheo sa ho phekola, ho phela ka kakaretso ka phekolo ea neoadjuvant e ne e le likhoeli tse 25.1 ha li bapisoa le likhoeli tse 38.5 ka ho buuoa ka pele, 'me chemotherapy ea neoadjuvant e ile ea eketsa kotsi ea ho phela ka 52% (95% CI 0.94-2.46, P = 0.06).Sekhahla sa ho pholoha ha likhoeli tse 18 e ne e le 60% ka neoadjuvant FOLFIRINOX le 73% ka ho buuoa pele.Liteko tsa protocol li hlahisitse liphetho tse tšoanang.
Liphetho tsa Histopathological li rata chemotherapy ea neoadjuvant kaha 56% ea bakuli ba fihletse boemo ba R0 ha ba bapisoa le 39% ea bakuli ba ho buuoa ka pele (P = 0.076) le 29% ba fihletse boemo ba N0 ha ba bapisoa le 14% ea bakuli (P = 0.060).Tlhahlobo ea protocol e bontšitse phapang e kholo ea lipalo le neoadjuvant FOLFIRINOX boemong ba R0 (59% vs. 33%, P = 0.011) le boemo ba N0 (37% vs. 10%, P = 0.002).
Charles Bankhead ke mohlophisi e moholo oa oncology hape o akaretsa urology, dermatology le ophthalmology.O kene MedPage Kajeno ka 2007.
Boithuto bona bo ne bo tšehetsoa ke Mokhatlo oa Kankere oa Norway, Setsi sa Bophelo bo Botle ba Setereke sa South-East Norway, Sjoberg Foundation ea Sweden le Sepetlele sa Univesithi ea Helsinki.
Ko 披露了与 Clinical Care Options、Gerson Lehrman Group、Medscape、MJH Life Sciences、Research to Practice、AADi、FibroGen、Genentech、GRAIL、Ipsen、Merus、Roche、AbGenomics、Apexigen、Astellas、BioMed Valley Discoveries”My Discoveries .Celgene, CrystalGenomics, Leap Therapeutics le lik'hamphani tse ling.
Tlhaloso ea Mohloli: Labori KJ et al."Neoadjuvant ea nakoana ea FOLFIRINOX khahlano le opereishene ea pele bakeng sa mofets'e oa hlooho ea pancreatic: teko ea multicenter randomized phase II (NORPACT-1)," ASCO 2023;Setšoantšo sa LBA4005
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Nako ea poso: Sep-22-2023