Chemotherapy for small-bowel Adenocarcinoma at a single institution
Chemotherapy for small-bowel Adenocarcinoma at a single institution
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DOI：
10.1007/s00595-008-3843-2
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发表时间：
2009-01-01
期刊：
影响因子：
2.5
通讯作者：
Hatake, Kiyohiko
中科院分区：
文献类型：
--
作者：
Suenaga, Mitsukuni;Mizunuma, Nobuyuki;Hatake, Kiyohiko
小肠腺癌（SBA）是罕见的。目前还没有针对这种癌症的标准化疗方法。在癌症研究所医院（CIH），用于结直肠癌的化疗方案首先用于SBA患者，然后用于胃癌。回顾性分析了在CIH接受化疗的晚期或复发性SBA患者。一线治疗是氟尿嘧啶单独使用或与其他药物联合使用，如5-氟尿嘧啶加甲酰四氢叶酸（FL）、UFT-E或TS-1。二线治疗为伊立替康（CPT-11）单药治疗，10例患者使用以氟嘧啶为主的方案，主要为FL。7例患者接受了CPT-11二线治疗方案。在一线化疗的5名患者（50%）和二线化疗的3名患者（43%）中观察到疾病控制。中位总生存期为12个月（范围3-39）。这些治疗通常是耐受的。不良反应以消化道症状为主，氟尿嘧啶一线化疗和CPT-11二线化疗反应低，但不良反应轻微。FOLFOX和FOLFIRI方案（如用于转移性结直肠癌的方案）是潜在的替代策略。需要进行广泛的试验来开发新药物的标准化疗。
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.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.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.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.