Unresectable duodenal
adenocarcinoma excluding the ampullary region is rare, and no standard
chemotherapy has been defined for this disease. Although S-1-based
chemotherapy is widely administered for advanced
gastric cancer, few reports have described advanced
duodenal cancer treated with S-1-based
chemotherapy. We present herein a case of duodenal
adenocarcinoma with liver
metastases. The patient was a 72-year-old man with chief complaints of epigastralgia and
fever. Gastroduodenal endoscopy revealed an ulcerative lesion on the upper wall of the duodenal bulb, and biopsy specimens showed well-differentiated
adenocarcinoma. Computed tomography and ultrasonography showed multiple liver
metastases. S-1 (80 mg/m(2) day(-1) on days 1-21) + irinotecan (80 mg/m(2) day(-1) on days 1 and 15) were administered in 4-week intervals as first-line
chemotherapy.
Tumor markers subsequently normalized, and liver
metastases were diminished. The progression-free term was 6 months. Grade 3
neutropenia and
diarrhea were observed as adverse events. S-1 + cisplatin and S-1 + docetaxel were administered as second- and third-line
chemotherapies, respectively. The patient died due to
hepatic failure, with an overall survival of 15 months. S-1-based regimens appear effective and well tolerated, and S-1 may thus represent a useful option for advanced
duodenal cancer.