Meta-analysis of FOLFIRINOX and GNP neoadjuvant chemotherapy in the treatment of patients with borderline resectable and locally advanced pancreatic adenocarcinoma
Objective To systematically evaluate the efficacy and safety of FOLFIRINOX and albumin-bound paclitaxel combined with gemcitabine(GNP)neoadjuvant chemotherapy in the treatment of patients with borderline resectable or locally advanced pancreatic cancer(BRPC/LAPC).Methods Multiple Chinese and English databases were searched by computer,and the time range was set to be from the database establishment time to November 31,2023.Data on the effectiveness and safety of FOLFIRINOX regimen and GNP regimens in the treatment of BRPC/LAPC were collected.Meta analysis was conducted using Rev Man 5.3 statistical software.Results The FOLFIRINOX group had a longer progression-free survival than the GNP group,but the incidence of disease progression was higher than that of the GNP group(P＜0.05).There was no statistically significant difference between the two groups in overall survival,complete remission,partial remission,disease stability,objective remission rate,and disease control rate(P＞0.05).FOLFIRINOX group had a lower incidences of overall anemia,grade 3-4 anemia,overall fatigue,and grade 3-4 fatigue compared to the GNP group(P＜0.05).The incidences of grade 3-4 diarrhea,overall peripheral neuropathy,and grade 3-4 peripheral neuropathy were significantly higher in the GNP group than FOLFIRINOX group(P＜0.05).Conclusion Compared with the current two first-line chemotherapy regimens for BRPC/LAPC,FOLFIRINOX regimen has a longer progression-free survival period than GNP regimen,but the incidence of disease progression is higher;The toxic side effects of FOLFIRINOX are mainly anemia and fatigue,while the toxic side effects of GNP are mainly diarrhea and peripheral neuropathy.
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