[A case report of primary duodenal adenocarcinoma responding to chemotherapy with S-1 and irinotecan].

A 5 3-year-old woman was admitted to our hospital because of vomiting. CT scan and gastroduodenoscopy showed severe stenosis of the duodenal 3rd portion. There was no evidence of malignancy. We diagnosed a stricture due to a duodenal ulcer and laparotomy was performed. By means of biopsy of No.14d lymph node in the operation, adenocarcinoma of the duodenum was pointed out and we performed a pancreatoduodenectomy. Although adjuvant chemotherapy with S-1/paclitaxel (S-1 80 mg/body, po, day 1-14 and paclitaxel 120 mg/body iv day 1, 8)was administered after operation, the patient's serum CEA was elevated and metastic lymph nodes around the supra mesenteric artery were pointed out. The patient was started on combined chemotherapy with S-1/CPT-11(S-1 80 mg/body, po, day 1-14 and CPT-11 120 mg/body iv day 1), serum CEA levels returned to normal range, and marked reduction of lymph node size was observed on CT. The patient is still alive and free of disease three years after the operation. S-1/CPT-11 could therefore be a treatment option for patients with duodenal carcinoma.