Oxaliplatin/5-fluorouracil/leucovorin (FOLFOX4) regimen as an adjuvant chemotherapy in the treatment of advanced jejunal adenocarcinoma: a report of 2 cases.
OBJECTIVE
To present our clinical experience of 5-fluorouracil/leucovorin/oxaliplatin (FOLFOX4) regimen administered as an adjuvant chemotherapy to 2 patients with advanced jejunal adenocarcinoma.


METHODS
A 55-year-old woman presented with recurrent upper abdominal pain, nausea and vomiting. A small bowel series as well as the abdominal computed tomography scan revealed an irregular narrowing lesion at the proximal jejunum. The patient then underwent an exploratory laparotomy and the jejunal adenocarcinoma with localized peritoneal metastasis was found (R0 resection, T3N1M1, stage IV). Chemotherapy with FOLFOX4 regimen of 12 cycles was initiated after the curative resection. No adverse event was observed during the period of chemotherapy. She has been well without evidence of recurrence for over 20 months postoperatively. The second case was a 77-year-old female presenting with mechanical ileus. Surgical exploration revealed a proximal jejunal adenocarcinoma with regional lymph node involvement (R0 resection, T3N1M0, stage III). She also received the FOLFOX4 chemotherapy of 12 cycles with an uneventful course. No obvious toxicity developed except for temporary grade I peripheral neuropathy and skin eruption. This patient has survived well and has been free of this disease for over 12 months since the operation.


CONCLUSIONS
This report showed that adjuvant chemotherapy with FOLFOX4 regimen seems effective and well tolerated in these 2 patients with advanced jejunal adenocarcinoma. Further investigation of a large number of patients with long-term follow-up is needed to confirm these findings.
Chen
Chao-Wen
CW
Department of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Wang
Wen-Ming
WM
Su
Yu-Chung
YC
Wu
Jeng-Yih
JY
Hsieh
Jan-Sing
JS
Wang
Jaw-Yuan
JY
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D007580:Jejunal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D002955:Leucovorin / Q000627:therapeutic use; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000556:secondary
D009944:Organoplatinum Compounds; D002955:Leucovorin; D005472:Fluorouracil