Download PDF
Dtsch Med Wochenschr 2003; 128(37): 1902-1907
DOI: 10.1055/s-2003-42159
Übersichten
© Georg Thieme Verlag Stuttgart · New York

Therapeutische Strategien beim kolorektalen Karzinom

Therapeutic strategies in colorectal cancerD. Flieger1 , R. Keller1 , W. Fischbach1
  • 1Medizinische Klinik II (Chefarzt: Prof. Dr. W. Fischbach), Aschaffenburg
Further Information

Publication History

eingereicht: 18.7.2003

akzeptiert: 21.8.2003

Publication Date:
11 September 2003 (online)

Also available at
    Permissions and Reprints

Epidemiologie

In Deutschland sind schätzungsweise über 50000 Neuerkrankungen an kolorektalem Karzinom jährlich zu verzeichnen. Ca. 35000 Menschen sterben an diesem Malignom jährlich. Das Risiko, an einem kolorektalen Karzinom zu erkranken, ist altersabhängig. Das Lebenszeitrisiko beträgt in Deutschland 4-6 %, ab dem 50. Lebensjahr verdoppeln sich Inzidenz und Mortalität mit jeder Lebensdekade. Die Gesamtinzidenz des Kolonkarzinoms stieg in den letzten Jahrzehnten stetig an. Aufgrund verbesserter Vorsorgemaßnahmen ist jetzt eine rückläufige Tendenz zu verzeichnen [20].

Literatur

  • 1 Aranda E, Anton-Torres A, Sastre J. et al . Tegafur and uracil plus leucovorin in advanced colorectal cancer: a phase II trial.  Clin Colorectal Cancer. 2001;  1 43-46
    Google Scholar
  • 2 Ardalan B, Chua L, Tian E M. et al . A phase II study of weekly 24-hour infusion with high-dose fluorouracil with leucovorin in colorectal carcinoma.  J Clin Oncol. 1991;  9 625-630
    Google Scholar
  • 3 Douillard J Y, Cunningham D, Roth A D. et al . Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicentre randomised trial.  Lancet. 2000;  355 1041-1047
    Google Scholar
  • 4 Elsaleh H, Joseph D, Grieu F, Zeps N, Spry N, Iacopetta B. Association of tumour site and sex with survival benefit from adjuvant chemotherapy in colorectal cancer.  Lancet. 2000;  355 1745-1750
    Google Scholar
  • 5 Flieger D, Spengler U, Beier I, Sauerbruch T, Schmidt-Wolf I G. Prestimulation of monocytes by the cytokines GM-CSF or IL-2 enhances the antibody dependent cellular cytotoxicity of monoclonal antibody 17 - 1A.  Z Gastroenterol. 2000;  38 615-622
    Google Scholar
  • 6 Giacchetti S, Itzhaki M, Gruia G. et al . Long-term survival of patients with unresectable colorectal cancer liver metastases following infusional chemotherapy with 5-fluorouracil, leucovorin, oxaliplatin and surgery.  Ann Oncol. 1999;  10 663-669
    Google Scholar
  • 7 Giacchetti S, Perpoint B, Zidani R. et al . Phase III multicenter randomized trial of oxaliplatin added to chronomodulated fluorouracil-leucovorin as first-line treatment of metastatic colorectal cancer.  J Clin Oncol. 2000;  18 136-1347
    Google Scholar
  • 8 Glimelius B, Hoffman K, Graf W, Pahlman L, Sjoden P O. The Nordic Gastrointestinal Tumor Adjuvant Therapy Group . Quality of life during chemotherapy in patients with symptomatic advanced colorectal cancer.  Cancer. 1994;  73 556-562
    Google Scholar
  • 9 Glimelius B, Jakobsen A, Graf W. et al. Nordic Gastrointestinal Tumour Adjuvant Therapy Group . Bolus injection (2 - 4 min) versus short-term (10 - 20 min) infusion of 5-fluorouracil in patients with advanced colorectal cancer: a prospective randomised trial.  Eur J Cancer. 1998;  34 674-678
    Google Scholar
  • 10 Heald R J, Moran B J, Ryall R D, Sexton R, MacFarlane J K. Rectal cancer: the Basingstoke experience of total mesorectal excision, 1978 - 1997.  Arch Surg. 1998;  133 894-899
    Google Scholar
  • 11 Hurwitz H, Fehrenbacher L, Cartwright T. et al . Bevacizumab (a monoclonal antibody to vascular endothelial growth factor) prolongs survival in first-line colorectal cancer (CRC): Results of a phase III trial of bevacizumab in combination with bolus IFL (irinotecan, 5-fluorouracil, leucovorin) as first-line therapy in subjects with metastatic CRC.  Proc ASCO. 2003;  22 3646
    Google Scholar
  • 12 Kapiteijn E, Marijnen C A, Nagtegaal I D. et al . Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer.  N Engl J Med. 2001;  345 638-646
    Google Scholar
  • 13 Kemeny M M, Adak S, Gray B. et al . Combined-modality treatment for resectable metastatic colorectal carcinoma to the liver: surgical resection of hepatic metastases in combination with continuous infusion of chemotherapy-an intergroup study.  J Clin Oncol. 2002;  20 1499-1505
    Google Scholar
  • 14 Lee J H, Ahn J H, Bahng H. et al . Randomized trial of postoperative adjuvant therapy in stage II and III rectal cancer to define the optimal sequence of chemotherapy and radiotherapy: a preliminary report.  J Clin Oncol. 2002;  20 1751-1758
    Google Scholar
  • 15 Lokich J J, Ahlgren J D, Gullo J J, Philips J A, Fryer J G. A prospective randomized comparison of continuous infusion fluorouracil with a conventional bolus schedule in metastatic colorectal carcinoma: a Mid-Atlantic Oncology Program Study.  J Clin Oncol. 1989;  7 425-432
    Google Scholar
  • 16 Mandel J S, Church T R, Bond J H. et al . The effect of fecal occult-blood screening on the incidence of colorectal cancer.  N Engl J Med. 2000;  343 1603-1607
    Google Scholar
  • 17 Maughan T S, James R D, Kerr D J. et al . Comparison of intermittent and continuous palliative chemotherapy for advanced colorectal cancer: a multicentre randomised trial.  Lancet. 2003;  361 457-464
    Google Scholar
  • 18 Minsky B D, Cohen A M, Kemeny N. et al . Pre-operative combined 5-FU, low dose leucovorin, and sequential radiation therapy for unresectable rectal cancer.  Int J Radiat Oncol Biol Phys. 1993;  25 821-827
    Google Scholar
  • 19 Moertel C G, Fleming T R, Macdonald J S. et al . Fluorouracil plus levamisole as effective adjuvant therapy after resection of stage III colon carcinoma: a final report.  Ann Intern Med. 1995;  122 321-326
    Google Scholar
  • 20 Nelson R L, Persky V, Turyk M. Determination of factors responsible for the declining incidence of colorectal cancer.  Dis Colon Rectum. 1999;  42 741-752
    Google Scholar
  • 21 NIH consensus conference . Adjuvant therapy for patients with colon and rectal cancer.  JAMA. 1990;  264 1444-1450
    Google Scholar
  • 22 Nordic Gastrointestinal Tumor Adjuvant Therapy Group . Expectancy or primary chemotherapy in patients with advanced asymptomatic colorectal cancer: a randomized trial.  J Clin Oncol. 1992;  10 904-911
    Google Scholar
  • 23 Nordlinger B, Vaillant J C, Guiguet M. et al . Survival benefit of repeat liver resections for recurrent colorectal metastases: 143 cases. Association Francaise de Chirurgie.  J Clin Oncol. 1994;  12 1491-1496
    Google Scholar
  • 24 O’Connell M J, Martenson J A, Wieand H S. et al . Improving adjuvant therapy for rectal cancer by combining protracted-infusion fluorouracil with radiation therapy after curative surgery.  N Engl J Med. 1994;  331 502-507
    Google Scholar
  • 25 Patt Y Z, Mavligit G M. Arterial chemotherapy in the management of colorectal cancer: an overview.  Semin Oncol. 1991;  18 478-490
    Google Scholar
  • 26 Poon M A, O’Connell M J, Moertel C G. et al . Biochemical modulation of fluorouracil: evidence of significant improvement of survival and quality of life in patients with advanced colorectal carcinoma.  J Clin Oncol. 1989;  7 1407-1418
    Google Scholar
  • 27 Porschen R, Bermann A, Loffler T. et al . Fluorouracil plus leucovorin as effective adjuvant chemotherapy in curatively resected stage III colon cancer: results of the trial adjCCA-01.  J Clin Oncol. 2001;  19 1787-1794
    Google Scholar
  • 28 Punt C JA, Nagy A, Douillard J Y. et al . Edrecolomab (17 - 1A Antibody) alone or in combination with 5-Fluorouracil based chemotherapy in the adjuvant treatment of stage III colon cancer: Results of a phase III study.  Proc ASCO. 2001;  20 487
    Google Scholar
  • 29 Ribic C M, Sargent D J, Moore M J. et al . Tumor microsatellite-instability status as a predictor of benefit from fluorouracil-based adjuvant chemotherapy for colon cancer.  N Engl J Med. 2003;  349 247-257
    Google Scholar
  • 30 Riethmüller G, Holz E, Schlimok G. et al . Monoclonal antibody therapy for resected Dukes’ C colorectal cancer: seven-year outcome of a multicenter randomized trial.  J Clin Oncol. 1998;  16 1788-1794
    Google Scholar
  • 31 Salonga D, Danenberg K D, Johnson M. et al . Colorectal tumors responding to 5-fluorouracil have low gene expression levels of dihydropyrimidine dehydrogenase, thymidylate synthase, and thymidine phosphorylase.  Clin Cancer Res. 2000;  6 1322-1327
    Google Scholar
  • 32 Saltz L B, Cox J V, Blanke C. et al. Irinotecan Study Group . Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer.  N Engl J Med. 2000;  343 905-914
    Google Scholar
  • 33 Saltz L, Rubin M, Hochster H. et al . Cetuximab (IMC-C225) plus irinotecan (CPT-11) is active in CPT-11-refractory colorectal cancer (CRC) that expresses epidermal growth factor receptor (EGFR).  Proc ASCO. 2001;  20 7
    Google Scholar
  • 34 Schmoll H, Köhne C, Lorenz M. et al . Weekly 24 hInfusion of High-Dose (HD) 5-Fluorouracil (5-FU24h) with or Without Folinic Acid (FA) vs. Bolus 5-FU/FA (NCCTG/Mayo) in Advanced Colorectal Cancer (CRC): A Randomized Phase III Study of the EORTC GITCCG and the AIO.  Proc ASCO. 2000;  19 935
    Google Scholar
  • 35 Scheithauer W, Rosen H, Kornek G V, Sebesta C, Depisch D. Randomised comparison of combination chemotherapy plus supportive care with supportive care alone in patients with metastatic colorectal cancer.  BMJ. 1993;  306 752-755
    Google Scholar
  • 36 Simmonds P C. Colorectal Cancer Collaborative Group . Palliative chemotherapy for advanced colorectal cancer: systematic review and meta-analysis.  BMJ. 2000;  321 531-535
    Google Scholar
  • 37 Stangl R, Altendorf-Hofmann A, Charnley R M, Scheele J. Factors influencing the natural history of colorectal liver metastases.  Lancet. 1994;  343 1405-1410
    Google Scholar
  • 38 Steele G, Bleday R, Mayer R J, Lindblad A, Petrelli N, Weaver D. A prospective evaluation of hepatic resection for colorectal carcinoma metastases to the liver: Gastrointestinal Tumor Study Group Protocol 6584.  J Clin Oncol. 1991;  9 1105-1112
    Google Scholar
  • 39 Tournigand C, Louvet C, Quinaux E. et al . FOLFIRI followed by FOLFOX versus FOLFOX followed by FOLFIRI in metastatic colorectal cancer (MCRC): final results of a phase III study.  Proc ASCO. 2001;  20 494
    Google Scholar
  • 40 Towler B, Irwig L, Glasziou P, Kewenter J, Weller D, Silagy C. A systematic review of the effects of screening for colorectal cancer using the faecal occult blood test, hemoccult.  BMJ. 1998;  317 559-565
    Google Scholar
  • 41 Twelves C. Capecitabine as first-line treatment in colorectal cancer: Pooled data from two large, phase III trials.  Eur J Cancer. 2002;  38 15-20
    Google Scholar

Priv.-Doz. Dr. D. Flieger

Medizinische Klinik II, Klinikum Aschaffenburg

Am Hasenkopf

63739 Aschaffenburg

      >