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Background and purpose: Small bowel adenocarcinoma (SBA) is uncommon, and frequently diagnosed at late stage. Chemotherapy is the main treatment method for advanced SBA. Despite recent progress in SBA therapy, no standard regimen has been established up to now, and new active regimen is expected to improve the outcome of this disease. The purpose of this study was to evaluate the efifcacy and safety of S-1/oxaliplatin for the treatment of advanced SBA. Methods:In a retrospective study, clinical characteristics and outcomes of 29 patients with advanced SBA were collected and analyzed. Patients received oral S-1 40 mg/m2, twice daily, d1-14, oxaliplatin was administered intravenously 130 mg/m2 on the ifrst day of every cycle, repeated every 3 weeks. Efifcacy and toxicity were evaluated after at least two consecutive cycles. Results:All patients were evaluated for efifcacy and safety. The objective response and disease control rates were 37.9%and 65.5%, respectively. The median progression-free survival and overall survival were 5.4 months (95%CI:3.6-7.2) and 13.2 months (95%CI:6.7-19.7), respectively. In univariate analysis, the following factors were signiifcantly associated with poor outcome:not ifrst line chemotherapy setting, ECOG performance status>1 and sites of metastasis>2 (Log-rank, P<0.05). The treatment related adverse events were mild and manageable. Myelosuppression, gastrointestinal reaction, fatigue, sensory neuropathy and rash were the most common toxicities. Conclusion:This study was the ifrst to report the efifcacy of S-1 combined with oxaliplatin for advanced SBA. S-1/oxaliplatin may be effective and safe for advanced SBA and worthy of further study.
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Objective:To investigate the mechanism and effects of autophagy on cisplatin(DDP)-induced apoptosis in human gas-tric cancer cell line SGC7901. Methods:Cell proliferation was determined by an MTT assay after the SGC7901 cells were treated with DDP and/or chloroquine. Cell apoptosis was determined by flow cytometry. Autophagy and related protein expressions were detected by Western blot. Autophagy was quantitatively analyzed by fluorescence microscopy after monodansylcadaverine staining was per-formed. Results:The cells were treated with 5 mg/L of DDP for 24 h, the rate of cell apoptosis was (21.07 ± 2.12)%. Autophagy, char-acterized by an increase in the number of autophagic vesicles and LC3-II protein level, was observed in DDP-treated cells. After autoph-agy was inhibited by chloroquine, the rate of cell apoptosis was increased to (30.16 ± 3.54)%. In addition, caspase-3 and P53 protein levels were increased, but Bcl-2 protein was decreased. Conclusion:Autophagy protected human gastric cancer cell line SGC7901 from DDP-induced apoptosis. In addition, the inhibition of autophagy could promote apoptosis. The combined therapy of DDP and chlo-roquine may be a promising therapeutic strategy for gastric cancer.