A Retrospective Study of Folfox in the Treatment of Patients with Advanced Duodenal Adenocarcinoma: A Japanese Single-Center Experience.

457 Background: Duodenal adenocarcinoma is a rare tumor with poor prognosis. There is little data on the efficacy of chemotherapy for this disease. Methods: The current study included data from all consecutive patients who were diagnosed as having duodenal adenocarcinoma at our hospital between October 2008 and December 2013. Selection criteria were as follows: patients who 1) had histologically confirmed duodenal adenocarcinoma, 2) were diagnosed as having unresectable or recurrent disease, and 3) received first-line chemotherapy with infusional 5-FU, leucovorin and oxaliplatin (FOLFOX). We examined efficacy and toxicity of FOLFOX therapy from the case cards and analyzed their survival data. Results: There were 20 patients who met the selection criteria. The median age was 67.5 years (range, 35-76). Of the 20, 11 (45%) were male, 17 (85%) had a good performance status, 15 (75%) had received resection of the primary tumor, and 13 (65%) had a liver metastasis. They received median of 8 (range, 1-32) chemotherapy cycles. There was no complete response. Of the 20, 4 (20%) achieved partial response, 9 (45%) remained stable disease, 6 (30%) showed progressive disease and the remaining one did not have a CT evaluation. The median progression free survival and overall survival months from the initiation of FOLFOX therapy were 5.0 and 11.7, respectively. Grade 3/4 toxicities were observed in 9 (45%). Although there was no febrile neutropenia, grade 3/4 neutropenia was observed in 7 (35%). Treatment-related death due to pneumonitis was documented in one. Whereas prognostic factor was not found in multivariate analysis, a peritoneum metastasis tended to be associated with poor progression free survival (p=0.06). Conclusions: The FOLFOX therapy shows moderately activity with acceptable toxicities for the treatment of advanced duodenal adenocarcinoma.