Skip to main content
Log in

Adjuvante Chemotherapie bei soliden Tumoren des Gastrointestinaltrakts

Sind Fortschritte zu erkennen?

Adjuvant chemotherapy of solid tumors of the gastrointestinal tract: Where is the progress?

  • Schwerpunkt: Was ist gesichert in der Therapie?
  • Published:
Der Internist Aims and scope Submit manuscript

Zusammenfassung

Eine chirurgische Therapie strebt die vollständige Entfernung eines Tumors aus dem Organismus an. Eine anschließende adjuvante Chemotherapie soll durch die Beseitigung verbliebener Tumorzellen das Rezidiv verhindern und damit die langfristige Heilung verbessern. In den letzten Jahren konnte durch multimodale Konzepte, unter Einbeziehung neuer Kombinationschemotherapieschemata und innovativer Bestrahlungskonzepte, die langfristige Prognose für den einzelnen Patienten verbessert werden. Ziel dieser Übersicht ist es, die aktuellen Konzepte für ausgewählte Tumore des Gastrointestinaltrakts vorzustellen und zu bewerten.

Abstract

Surgical therapy of any malignancy always attempts the complete removal of a cancer from the organism. An adjuvant chemotherapy has the goal to remove remaining tumor-cells, to prevent recurrence of the disease and to improve long term survival. Within the last years there has been a substantial improvement in prognosis due to multi-modal therapeutic regimens including combination-chemo-therapy and innovative radiation-protocols. This review aims to present and to critically review current concepts in the treatment of selected tumors of the gastrointestinal tract.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Abb. 1

Literatur

  1. Andre T, Boni C, Mounedji-Boudiaf L et al. Multicenter International Study of Oxaliplatin/5-Fluorouracil/Leucovorin in the Adjuvant Treatment of Colon Cancer (MOSAIC) Investigators (2004) Oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment for colon cancer. N Engl J Med 350: 2343–2351

    Article  PubMed  CAS  Google Scholar 

  2. Bonenkamp JJ, Hermans J, Sasako M et al. Dutch Gastric Cancer Group (1999) Extended lymph-node dissection for gastric cancer. N Engl J Med 340: 908–920

    Article  PubMed  CAS  Google Scholar 

  3. Cunningham D, Allum WH, Stenning SP et al. (2006) Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 355: 11–20

    Article  PubMed  CAS  Google Scholar 

  4. Fong Y (2000) Hepatic colorectal metastasis: current surgical therapy, selection criteria for hepatectomy, and role for adjuvant therapy. Adv Surg 34: 351–381

    PubMed  CAS  Google Scholar 

  5. Janunger KG, Hafstrom L, Glimelius B (2002) Chemotherapy in gastric cancer: a review und updated meta-analysis. Eur J Surg 168: 597–608

    Article  PubMed  CAS  Google Scholar 

  6. Kopec JA, Yothers G, Ganz PA et al. (2007) Quality of life in operable colon cancer patients receiving oral compared with intravenous chemotherapy: results from National Surgical Adjuvant Breast and Bowel Project Trial C-06. J Clin Oncol 25: 424–430

    Article  PubMed  Google Scholar 

  7. Kuebler JP, Wieand HS, O’Connell MJ et al. (2007) Oxaliplatin combined with weekly bolus fluorouracil and leucovorin as surgical adjuvant chemotherapy for stage II and III colon cancer: results from NSABP C-07. J Clin Oncol 25: 2198–2204

    Article  PubMed  CAS  Google Scholar 

  8. Land SR, Kopec JA, Cecchini RS et al.(2007) Neurotoxicity from oxaliplatin combined with weekly bolus fluorouracil and leucovorin as surgical adjuvant chemotherapy for stage II and III colon cancer: NSABP C-07. J Clin Oncol 25: 2205–2211

    Article  PubMed  CAS  Google Scholar 

  9. Macdonald JS, Smalley SR, Benedetti J et al. (2001) Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med 345: 725–730

    Article  PubMed  CAS  Google Scholar 

  10. Moertel CG, Fleming TR, Macdonald JS et al. (1995) Fluorouracil plus levamisole as effective adjuvant therapy after resection of stage III colon carcinoma: a final report. Ann Intern Med 122: 321–326

    PubMed  CAS  Google Scholar 

  11. Neoptolemos JP, Dunn JA, Stocken DD et al. (2001) European Study Group for Pancreatic Cancer Adjuvant chemoradiotherapy and chemotherapy in resectable pancreatic cancer: a randomised controlled trial. Lancet 358: 1576–1585

    Article  PubMed  CAS  Google Scholar 

  12. Neoptolemos JP, Stocken DD, Friess H et al. (2004) A randomized trial of chemora- diotherapy and chemotherapy after resection of pancreatic cancer. N Engl J Med 350: 1200–1210

    Article  PubMed  CAS  Google Scholar 

  13. O’Connell JB, Maggard MA, Ko CY (2004) Colon cancer survival rates with the new American Joint Committee on Cancer sixth edition staging. J Natl Cancer Inst 96: 1420–1425

    Article  Google Scholar 

  14. Oettle H, Post S, Neuhaus P et al. (2007) Adjuvant chemotherapy with gemcitabine vs observation in patients undergoing curative-intent resection of pancereatic cancer: A randomized controlled trial. JAMA 297: 269–277

    Google Scholar 

  15. Popat S, Hubner R, Houlston RS (2005) Systematic review of microsatellite instability and colorectal cancer prognosis. J Clin Oncol 23: 609–618

    Article  PubMed  CAS  Google Scholar 

  16. Portier G, Elias D, Bouche O et al. (2006) Multicenter randomized trial of adjuvant fluorouracil and folinic acid compared with surgery alone after resection of colorectal liver metastases: FFCD ACHBTH AURC 9002 trial. J Clin Oncol 24: 4976–4982

    Article  PubMed  CAS  Google Scholar 

  17. Poston GJ, Adam R, Alberts S et al. (2005) OncoSurge: a strategy for improving resectability with curative intent in metastatic colorectal cancer. J Clin Oncol 23: 7125–7134

    Article  PubMed  Google Scholar 

  18. Rothenberg ML, Meropol NJ, Poplin EA et al. (2001) Mortality associated with irinotecan plus bolus fluorouracil/leucovorin: summary findings of an independent panel. J Clin Oncol 19: 3801–3807

    PubMed  CAS  Google Scholar 

  19. Twelves CJ (2006) Xeloda in Adjuvant Colon Cancer Therapy (X-ACT) trial: overview of efficacy, safety, and cost-effectiveness. Clin Colorectal Cancer 6: 278–287

    Article  PubMed  CAS  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to T. Seufferlein.

Rights and permissions

Reprints and permissions

About this article

Cite this article

von Wichert, G., Seufferlein, T. Adjuvante Chemotherapie bei soliden Tumoren des Gastrointestinaltrakts. Internist 48, 1335–1342 (2007). https://doi.org/10.1007/s00108-007-1974-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00108-007-1974-y

Schlüsselwörter

Keywords

Navigation