Chemotherapy for primary adenocarcinoma of the small bowel

The results of chemotherapy for patients with advanced adenocarcinoma of the small bowel treated at U. T. M. D. Anderson Hospital between 1950 and 1980 were analyzed. A total of 21 single-agent and multidrug chemotherapy regimens were given to 14 patients. 5-Fluorouracil, Adriamycin, mitomycin C, and nitrosourea compounds were the most commonly used chemotherapeutic agents. Fluoropyrimidines, used alone or in combination with the other agents mentioned above, resulted in objective tumor regression in 3 patients (1 partial and 2 minor responses); while 9 additional patients had stable disease. The partial response (PR) was obtained with ftorafur in a patient with supraclavicular lymphadenopathy and hepatic metastasis. Median duration of survival for patients treated with chemotherapy was 9 months. Results of this study show that adenocarcinoma of the small bowel appears to be somewhat less responsive to chemotherapeutic agents than adenocarcinoma arising in the stomach, as reported in the literature. Systematic evaluations of the efficacy of new antitumor agents is indicated to improve results of treatment for advanced small bowel adenocarcinomas.