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Adjuvante Therapie des Kolorektalkarzinoms

Adjuvant therapy of colorectal carcinoma

  • Published:
Acta Chirurgica Austriaca Aims and scope Submit manuscript

Zusammenfassung

Das kolorektale Adenokarzinom ist der in Österreich zweithäufigste solide Tumor. Trotz Radikaloperation von 60~80% aller Patienten stirbt rund die Hälfte am Tumorleiden. Neben einer Verbesserung der chirurgischen Techniken konnten jüngste Studien zeigen, daß die Radiotherapie beim Rektalkarzinom und die Chemotherapie beim Kolonkarzinom (5-Fluorouracil [5-FU] in Kombination mit Levamisol) als Zusatzbehandlung in Untergruppen sinnvoll eingesetzt werden können. Dafür gelten die nachfolgenden Empfehlungen:

  1. 1.

    Patienten mit Stadium I haben ein geringes Rezidivrisiko und bedürfen keiner adjuvanten Therapie.

  2. 2.

    Die optimale Therapie bei Stadium III und High-risk-Stadium II ist derzeit nicht bekannt. Patienten sollten daher vorzugsweise in Studien behandelt werden.

  3. 3.

    Ist eine Studienaufnahme nicht möglich, können Patienten außerhalb von Studien im Stadium III mit 5-FU/Levamisol behandelt werden, sofern keine Kontraindikationen bestehen.

  4. 4.

    Die postoperative Chemo- und Radiotherapie verbessert die lokale Tumorkontrolle und das Langzeitüberleben beim Rektumkarzinom der Stadien II und III.

Summary

Colorectal adenocarcinoma is the second most common solid tumor in Austria. Despite radical surgery in 60 to 80% of all cases, approximately 50% will have to die. In recent studies radiotherapy has shown to reduce local recurrence in rectal cancer and chemotherapy (5-FU/levamisole) to improve the overall survival in subsets of colorectal cancer. The following recommendations can be given:

  1. 1)

    Patients with stage I colorectal cancer do not need further treatment.

  2. 2)

    Since optimal therapeutic strategies of high risk stage II or stage III carcinoma are not known, patients should be assigned to controlled clinical trials.

  3. 3)

    Beside those trials, in isolated clinical conditions of stage III carcinoma, chemotherapy with 5-FU/levamisole can be administered, unless contraindicated.

  4. 4)

    Postoperative radio- and chemotherapy improves local tumor control and overall survival in rectal cancer of stages II or III.

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Authors and Affiliations

  1. Klinischen Abteilung für Onkologie der Universitätsklinik für Innere Medizin I, Währinger Gürtel 18-20, A-1090, Wien

    H. Rainer, R. M. Mader & G. Steger

  2. I. Chirurgischen Universitätsklinik, Währinger Gürtel 18-20, A-1090, Wien

    R. Jakesz

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  1. H. Rainer
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  2. R. M. Mader
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  3. G. Steger
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  4. R. Jakesz
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Rainer, H., Mader, R.M., Steger, G. et al. Adjuvante Therapie des Kolorektalkarzinoms. Acta Chir Austriaca 23, 235–238 (1991). https://doi.org/10.1007/BF02663233

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  • DOI: https://doi.org/10.1007/BF02663233

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