Department of Medical Oncology, Catharina Hospital, Eindhoven, the Netherlands.
Department of Research, Netherlands Comprehensive Cancer Organisation, Eindhoven, the Netherlands.
United European Gastroenterol J. 2019 Dec;7(10):1380-1388. doi: 10.1177/2050640619858211. Epub 2019 Jun 14.
As small-bowel adenocarcinoma (SBA) is scarce, no standard systemic regimen in metastatic disease has been defined.
To obtain insights into the use and effects of palliative chemotherapy in patients with metastatic SBA in a population-based setting.
Data from the Netherlands Cancer Registry of patients with metastatic SBA between 2007 and 2016 were used ( = 522). For patients treated with palliative chemotherapy, differences in treatment regimens and survival were evaluated.
Palliative chemotherapy was received by 38% of patients ( = 199). First-line combination chemotherapy was administered to 80% of patients, mainly CAPOX/FOLFOX. Single-agent chemotherapy mostly consisted of capecitabine. Second-line treatment, mostly irinotecan-based (58%), was prescribed to 27% of patients. Age 70 years or older was an adverse predictive factor for receiving first-line combination chemotherapy (odds ratio (OR) 0.2, 95% confidence interval (CI) 0.08-0.62) and second-line therapy (OR 0.3, 95% CI 0.10-0.72). Median overall survival with palliative chemotherapy was 9.3 months, compared with 3.0 months without. In subanalyses, patients who received only first-line treatment had a median overall survival of 5.6 and 7.0 months after single-agent and combination chemotherapy, respectively.
A minority of patients were treated with palliative chemotherapy. First-line treatment consisted predominantly of oxaliplatin-based combination chemotherapy, whereas second-line treatment was mainly irinotecan-based. Population-based median overall survival for selected patients treated with chemotherapy amounted to nine months.
由于小肠腺癌（SBA）较为罕见，因此在转移性疾病中尚未确定标准的系统治疗方案。
在基于人群的研究中，了解转移性 SBA 患者姑息化疗的使用情况和效果。
使用荷兰癌症登记处 2007 年至 2016 年期间转移性 SBA 患者的数据（ = 522）。评估接受姑息化疗的患者的治疗方案和生存差异。
38%的患者（ = 199）接受了姑息化疗。80%的患者接受了一线联合化疗，主要为 CAPOX/FOLFOX。单药化疗主要为卡培他滨。二线治疗（主要为伊立替康为基础治疗）占 27%，处方给 27%的患者。70 岁或以上是接受一线联合化疗（优势比（OR）0.2，95%置信区间（CI）0.08-0.62）和二线治疗（OR 0.3，95%CI 0.10-0.72）的不利预测因素。接受姑息化疗的患者中位总生存期为 9.3 个月，而未接受化疗的患者为 3.0 个月。在亚分析中，仅接受一线治疗的患者接受单药和联合化疗后的中位总生存期分别为 5.6 个月和 7.0 个月。
只有少数患者接受姑息化疗。一线治疗主要采用奥沙利铂为基础的联合化疗，而二线治疗主要采用伊立替康为基础的治疗。接受化疗的选定患者的基于人群的中位总生存期为九个月。
