Chemotherapy With 5-Fluorouracil and a Platinum Compound Improves Outcomes in Metastatic Small Bowel Adenocarcinoma
Chemotherapy With 5-Fluorouracil and a Platinum Compound Improves Outcomes in Metastatic Small Bowel Adenocarcinoma
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DOI：
10.1002/cncr.23822
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发表时间：
2008-10-15
期刊：
影响因子：
6.2
通讯作者：
Wolff, Robert A.
中科院分区：
文献类型：
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作者：
Overman, Michael J.;Kopetz, Scoff;Wolff, Robert A.
背景。转移性小肠腺癌（SBA）预后不良。由于SBA的罕见性，只有少数研究评估化疗在转移性SBA治疗中的作用；因此，在氟尿嘧啶（5-FU）中添加铂化合物是否有好处尚不清楚。这项回顾性研究的目的是确定在5-FU中添加铂化合物是否对转移性sba患者的治疗有任何益处。作者确定了1978年至2005年间在德克萨斯大学安德森癌症中心接受化疗的80例转移性SBA患者。比较了接受5-FU和铂类化合物治疗的患者与接受其他化疗联合治疗的患者的缓解率、无进展生存期（PFS）和总生存期（OS）。患者中位年龄为53岁。原发肿瘤部位为空肠35例（43%），十二指肠30例（38%），回肠6例（8%），小肠9例（11%）。在所有80例患者中，29例（36%）患者接受了5-FU和铂类化合物治疗，41例（51%）患者接受了不含铂类化合物的5-FU治疗，10例（13%）患者接受了非5-FU治疗。与其他化疗方案相比，5-FU联合铂类药物治疗的有效率更高（46%比16%，P = 0.01），中位PFS更长（8.7个月比3.9个月；P = 0.01）
BACKGROUND. Metastatic small bowel adenocarcinoma (SBA) has a poor prognosis. Because of the rarity of SBA, only a few studies have evaluated the role of chemotherapy in the treatment of metastatic SBA; thus, the benefit, if any, of adding a platinum compound to fluorouracil (5-FU) is unknown. The objective of this retrospective study was to determine whether the addition of a platinum compound to 5-FU provided any benefit in the treatment of patients with metastatic SBA.METHODS. The authors identified 80 patients with metastatic SBA who were treated with chemotherapy at the University of Texas M. D. Anderson Cancer Center between 1978 and 2005. Response rates, progression-free survival (PFS), and overall survival (OS) were compared between patients who received 5-FU and a platinum compound and patients who received other chemotherapy combinations.RESULTS. The median patient age was 53 years. The primary tumor site was the jejunum in 35 patients (43%), duodenum in 30 patients (38%), ileum in 6 patients (8%), and nonspecified small bowel in 9 patients (11%). Of all 80 patients, 29 patients (36%) received 5-FU and a platinum compound, 41 patients (51%) received 5-FU without a platinum compound, and 10 patients (13%) received non-5-FU-based treatment. Compared with other chemotherapy regimens, treatment with 5-FU and a platinum agent resulted in a higher response rate (46% vs 16% with other regimens; P = .01) and longer median PFS (8.7 months vs 3.9 months; P