Chemotherapy for small-bowel Adenocarcinoma at a single institution.
OBJECTIVE
Small-bowel adenocarcinoma (SBA) is rare. No standard chemotherapy for this type of cancer has yet been established. At Cancer Institute Hospital (CIH), the chemotherapy regimen used for colorectal cancer is initially used for patients with SBA, followed by that used for gastric cancer.


METHODS
Patients with advanced or recurrent SBA who had been treated with chemotherapy in CIH were retrospectively analyzed. The first-line treatments were fluoropyrimidines used alone or in combination with other drugs, such as 5-fluorouracil plus leucovorin (FL), UFT-E, or TS-1. The second-line treatment was irinotecan (CPT-11) monotherapy.


RESULTS
Fluoropyrimidine-based regimens, mainly FL, were used for 10 patients. Seven patients received the second-line CPT-11 regimen. Disease control was seen in five patients (50%) with the first-line chemotherapy and in three (43%) with the second-line. The median overall survival time was 12 months (range 3-39). The treatments were generally tolerated. Gastrointestinal symptoms were the most common adverse effects.


CONCLUSIONS
Fluoropyrimidines as the first-line and CPT-11 as the second-line chemotherapy yielded low response, although the adverse effects were mild. The FOLFOX and FOLFIRI regimens such as those used for metastatic colorectal cancer are potential alternative strategies. Extensive trials are needed to develop standard chemotherapy with new drugs.
Suenaga
Mitsukuni
M
Department of Medical Oncology, Cancer Institute Hospital, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
Mizunuma
Nobuyuki
N
Chin
Keisho
K
Matsusaka
Satoshi
S
Shinozaki
Eiji
E
Oya
Masatoshi
M
Ueno
Masashi
M
Yamaguchi
Toshiharu
T
Muto
Tetsuichiro
T
Konishi
Fumio
F
Hatake
Kiyohiko
K
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D018450:Disease Progression; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D005500:Follow-Up Studies; D006801:Humans; D007414:Intestinal Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality; D007421:Intestine, Small / Q000000981:diagnostic imaging; D000077146:Irinotecan; D002955:Leucovorin / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D014803:Vitamin B Complex / Q000008:administration & dosage / Q000009:adverse effects
D014803:Vitamin B Complex; D000077146:Irinotecan; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin