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The purpose of this study was to compare the effects of chemotherapy on the prognosis for patients with adenocarcinoma of the small bowel (SBC) and colorectal cancer (CRC). A case-control study was conducted, comprised of 13 SBC cases treated palliatively (n=7) following surgery with capecitabine monotherapy (Xeloda) combined with oxaliplatin (Xelox), or with adjuvant 5-fluorouracil chemotherapy (Mayo) (n=6). The control group was selected from a database of 581 patients with CRC, with each SBC case being matched to 5 CRC controls. In the palliative group, response rates (RR) for SBC patients were 14%, compared to 35% for CRC patients (p=0.08). Median progression-free survival (PFS) times were 4 and 6 months (p=0.8) and median overall survival (OS) times were 8.4 and 16.4 months (p=0.9) for SBC and CRC patients, respectively. In the adjuvant group, the recurrence-free survival rates were 66 and 89% (p=0.6) after 1 year and 66 and 71% (p=0.7) after 3 years. Three-year overall survival rates were 80 and 80% (p=0.3) in the palliative group, and 80 and 66% (p=0.4) in the adjuvant group. Standard chemotherapy regimes seemed less effective on SBC than on CRC patients, and had a less favorable prognosis. However, reliable conclusions cannot be drawn from a small patient population, and multicentre studies are needed.

oncology reports

Prognosis of small bowel adenocarcinoma treated with Mayo or Xelox regimen: A matched case-control study from a database of 581 patients with colorectal cancer