Folfirinox Neoadjuvant Therapy for Locally Advanced and Borderline Resectable Pancreatic Cancer - A Retrospective Study

ABSTRACT

Introduction: The management of borderline resectablepancreatic cancer has been heterogeneous and based onretrospective series. Historically, chemoradiotherapy had beenused to reduce the risk of a positive margin, local recurrence,and metastatic progression. Study was aimed to assess clinicaland pathologic efficacy of neoadjuvant FOLFIRINOX forlocally advanced (LAPC) and borderline resectable pancreaticcancer (BRPC).Material and Methods: In this retrospective study, patientsreceived neoadjuvant FOLFIRINOX for LAPC and BRPCwere included. Post-treatment patients achieving resectabilitywere referred for surgery, whereas unresectable patientscontinued chemotherapy. Clinical and pathological data wereretrospectively recorded.Results: The neoadjuvant group consisted of 29 PDACpatients, 16 with LAPC and 13 with BRPC who receivedneoadjuvant FOLFIRINOX. Reasons for non-resectabilityfollowing treatment included disease progression (10 patients),locally non-resectable disease (3 patients), and deteriorationof patient performance status (1 patient). Tumors size was1.87cm, the rate of lymphovascular invasion was 17.4%,the peripancreatic fat invasion was 52.2%, 22% of patientshad lymph node metastases. R0 resection was achieved inall patients. Evaluation of treatment response grading (TRG)demonstrated complete response (TRG 0) in 2 (15%) patients,and marked response (TRG 1) in 2 (15%) patients.Conclusion: Neoadjuvant FOLFIRINOX is aneffective, well-tolerated regimen for patientswith locally advanced and borderline resectable pancreaticcancer