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Chemotherapy of advanced small-bowel adenocarcinoma: a multicenter AGEO study.
- Source :
-
Annals of oncology : official journal of the European Society for Medical Oncology [Ann Oncol] 2010 Sep; Vol. 21 (9), pp. 1786-1793. Date of Electronic Publication: 2010 Mar 11. - Publication Year :
- 2010
-
Abstract
- Background: Small-bowel adenocarcinoma (SBA) is a rare tumor of poor prognosis. Data on the efficacy of chemotherapy for advanced SBA are scarce.<br />Patients and Methods: All patients with advanced SBA who received frontline chemotherapy from 1996 to 2008 were eligible for this retrospective multicenter study.<br />Results: Ninety-three consecutive patients were included. In the entire population, the median progression-free survival (PFS) and overall survival (OS) times were 6.6 and 15.1 months, respectively. Median PFS times among patients treated with LV5FU2 (n = 10), FOLFOX (n = 48), FOLFIRI (n = 19) and LV5FU2-cisplatin (n = 16) were 7.7, 6.9, 6.0 and 4.8 months, respectively, while median OS times were 13.5, 17.8, 10.6 and 9.3 months, respectively. In multivariate analysis, World Health Organization performance status (PS) (P < 0.0001) and elevated serum levels of carcinoembryonic antigen (CEA) (P = 0.02) and carbohydrate antigen 19-9 (CA 19-9) (P = 0.03) were the only variables significantly associated with poor OS. In the subgroup of patients treated with platinum-based chemotherapy, multivariate analysis showed that LV5FU2-cisplatin was associated with poorer PFS (P < 0.0001) and OS (P = 0.02) compared with FOLFOX.<br />Conclusions: This is the largest study of chemotherapy in advanced SBA. Baseline PS and CEA and CA 19-9 levels were the main prognostic factors. FOLFOX seems to be the most effective platinum-based chemotherapy regimen.
- Subjects :
- Adult
Aged
Aged, 80 and over
Camptothecin administration & dosage
Camptothecin analogs & derivatives
Cisplatin administration & dosage
Duodenal Neoplasms pathology
Female
Fluorouracil administration & dosage
Follow-Up Studies
Humans
Ileal Neoplasms pathology
Intestine, Small drug effects
Intestine, Small pathology
Irinotecan
Jejunal Neoplasms pathology
Leucovorin administration & dosage
Liver Neoplasms secondary
Lung Neoplasms secondary
Lymphatic Metastasis
Male
Middle Aged
Neoplasm Staging
Organoplatinum Compounds administration & dosage
Oxaliplatin
Peritoneal Neoplasms secondary
Prognosis
Retrospective Studies
Survival Rate
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Duodenal Neoplasms drug therapy
Ileal Neoplasms drug therapy
Jejunal Neoplasms drug therapy
Liver Neoplasms drug therapy
Lung Neoplasms drug therapy
Peritoneal Neoplasms drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1569-8041
- Volume :
- 21
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Annals of oncology : official journal of the European Society for Medical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 20223786
- Full Text :
- https://doi.org/10.1093/annonc/mdq038