ABSTRACT
Background & objectives: FOLFIRINOX and gemcitabine plus nab-paclitaxel (GN) are the most commonly used regimens in advanced pancreatic ductal adenocarcinomas (PDACs). As there is limited data on comparison of these two regimens, the present study was aimed to compare survivals and tolerance for both regimens through a match-pair analysis. Methods: The data of 350 patients with metastatic and locally advanced PDAC, treated between January 2013 and December 2019, were retrieved. A 1:1 matching, using age and performance status, without replacement was performed by using nearest neighbour matching method. Results: A total of 260 patients (130 modified FOLFIRINOX and 130 GN) were matched. The median overall survival (OS) was 12.98 months [95% confidence interval (CI) 7.257-8.776 months] in modifications of FOLFIRINOX (mFOLFIRINOX) cohort and 12.06 months (95% CI 6.690-8.88 months) in GN group (P=0.080). The incidence of grade 3 and 4 infections, diarrhoea, oral mucositis, and fatigue was higher with mFOLFIRINOX. Patients who received second line therapy had improved OS as compared to those who did not (14.06 vs. 9.07 months, P<0.001). Interpretation & conclusions: GN and mFOLFIRINOX appear to have similar survival outcomes in an unselected match paired patient population with advanced PDAC. A markedly increased incidence of non-myelosuppressive grade 3 and grade 4 side-effects and lack of survival improvements suggest a need for nuanced use of the mFOLFIRINOX regimen. Administration of second-line chemotherapy improves OS in patients with advanced PDAC.
ABSTRACT
Background: Recent advancements in diagnostic modalities for microalbuminuria have shown that urinaryexcretion of albumin is more in hypertensive patients as compared to subjects with normal blood pressure.Microalbuminuria is known to be associated with certain complications like dyslipidemia, cardiac complications,atherosclerosis and kidney disease. Purpose: To analyze the prevalence of microalbuminuria and its clinicalcorrelation with essential hypertension. Material and Methods: The study was of cross-sectional design,which was carried out in outpatient and inpatient departments of Medicine in DY Patil Medical School andHospital, Nerul, Navi Mumbai. Results: Out of total 190 study participants 96 were normotensive controls,while 94 were hypertensive patients. Mean age in control group was 48 ± 9.4 years, while that in hypertensivegroup, it was 49.2 ± 10.2 years. The 24 hours mean urinary excretion of albumin in hypertensive patients withmicroalbuminuria was found to be 80.21, while it was 12.91 and 7.89 in hypertensive patients withoutmicroalbuminuria and control groups, respectively. Conclusion: Early screening to detect microalbuminuriain early stages will help to initiate appropriate treatment regimen and prevent the risk of complications and thusimprovement in prognosis.