Multicenter Retrospective Study of 132 Patients with Unresectable Small Bowel Adenocarcinoma Treated with Chemotherapy

Abstract

Background.Nostandardchemotherapyregimenhasbeen established for unresectable or recurrent small bowel adenocarcinoma (SBA). Methods. Clinical courses of 132 patients with unresectable or recurrent SBA who received chemotherapy at 41 institutions in Japan were reviewed retrospectively. Patientswereclassifiedintofivegroupsaccordingtofirst-line chemotherapy regimens: fluoropyrimidine monotherapy (group A), fluoropyrimidine-cisplatin (group B), fluoropyrimidine-oxaliplatin (group C), fluoropyrimidine-irinotecan (group D), and other regimens (group E). Results.Thenumberofpatientsineachgroupwasasfollows: groups A, 60 patients; group B, 17 patients; group C, 22patients;groupD,11patients;andgroupE,22patients. Median progression-free survival (PFS) times were as follows: group A, 5.4 months; group B, 3.8 months; group C, 8.2months;groupD,5.6months;andgroupE,3.4months. Median overall survival (OS) times were as follows: group A, 13.9 months; group B, 12.6 months; group C, 22.2 months; group D, 9.4 months; and group D, 8.1 months. PatientsingroupCachievedsignificantlylongerPFStimes and substantially (but not significantly) longer OS times than patients in group A. After adjusting for clinical background characteristics, fluoropyrimidine-oxaliplatin therapywasasignificantpositiveprognosticfactorforPFSand OS times. Conclusion. The results suggest that fluoropyrimidineoxaliplatin combination therapy is the most promising first-linechemotherapyregimenforunresectableorrecurrent SBA. © AlphaMed Press.