Chemotherapy of advanced small-bowel adenocarcinoma: A multicenter AGEO study

A. Zaanan, L. Costes, M. Gauthier, D. Malka, C. Locher, E. Mitry, D. Tougeron, T. Lecomte, J. M. Gornet, I. Sobhani, V. Moulin, P. Afchain, J. Taïeb, F. Bonnetain, T. Aparicio

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128 Scopus citations


Background: Small-bowel adenocarcinoma (SBA) is a rare tumor of poor prognosis. Data on the efficacy of chemotherapy for advanced SBA are scarce. Patients and methods: All patients with advanced SBA who received frontline chemotherapy from 1996 to 2008 were eligible for this retrospective multicenter study. 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. 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.

Original languageEnglish
Pages (from-to)1786-1793
Number of pages8
JournalAnnals of Oncology
Issue number9
StatePublished - Sep 2010
Externally publishedYes


  • Chemotherapy
  • Prognostic factor
  • Small-bowel adenocarcinoma


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