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Chemotherapy for small-bowel Adenocarcinoma at a single institution

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Abstract

Purpose

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.

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Authors and Affiliations

  1. Department of Medical Oncology, Cancer Institute Hospital, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan

    Mitsukuni Suenaga, Nobuyuki Mizunuma, Keisho Chin, Satoshi Matsusaka, Eiji Shinozaki & Kiyohiko Hatake

  2. Division of Gastroenterological Surgery, Cancer Institute Hospital, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan

    Masatoshi Oya, Masashi Ueno, Toshiharu Yamaguchi & Tetsuichiro Muto

  3. Department of Surgery, Omiya Medical Center, Jichi Medical University, Saitama, Japan

    Fumio Konishi

Authors
  1. Mitsukuni Suenaga
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  2. Nobuyuki Mizunuma
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  3. Keisho Chin
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  4. Satoshi Matsusaka
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  5. Eiji Shinozaki
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  6. Masatoshi Oya
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  7. Masashi Ueno
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  8. Toshiharu Yamaguchi
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  9. Tetsuichiro Muto
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  10. Fumio Konishi
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  11. Kiyohiko Hatake
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Suenaga, M., Mizunuma, N., Chin, K. et al. Chemotherapy for small-bowel Adenocarcinoma at a single institution. Surg Today 39, 27–31 (2009). https://doi.org/10.1007/s00595-008-3843-2

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  • DOI: https://doi.org/10.1007/s00595-008-3843-2

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