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Adjuvant and neoadjuvant therapy in colorectal cancer

Adjuvante und neo-adjuvante Therapie bei Patienten mit kolorektalen Karzinomen

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Zusammenfassung

GRUNDLAGEN: Wie keine andere onkologische Erkrankung ist das kolorektale Karzinom in den letzten Jahren zum Aushängeschild für die optimale interdisziplinäre Zusammenarbeit zwischen Chirurgen, internistischen Onkologen und Strahlentherapeuten geworden. METHODIK: Dieser Artikel stellt den derzeitigen Stand der Behandlung des nicht-metastasierten kolorektalen Karzinoms vor. ERGEBNISSE: Mit der Einführung der adjuvanten Chemotherapie ist es gelungen, das progressionsfreie und das Gesamtüberleben von lokal fortgeschrittenem Kolonkarzinom signifikant zu verbessern. Die Prognose von Rektumkarzinomen dagegen wurde mit Hilfe der neoadjuvanten Chemoradiatio deutlich verbessert. SCHLUSSFOLGERUNGEN: Die Prognose von Patienten mit kolorektalen Karzinomen hat sich durch die modernen multidisziplinären Therapieansätze deutlich gebessert.

Summary

BACKGROUND: Like no other disease, colorectal cancer has become the poster child for optimal interdisciplinary collaboration of surgeons, medical oncologists and radiation therapists. METHODS: In this article, we present the current state-of-the-art treatment of non-metastatic colorectal cancer. RESULTS: Since the implementation of adjuvant chemotherapy it has become possible to significantly improve PFS and OS in locally advanced colon cancer. Disease-free survival, on the other hand, is considerably improved when treated with chemoradiation in a neoadjuvant fashion. CONCLUSIONS: The prognosis of colorectal cancer is dependent on a multidisciplinary approach employing state-of-the-art adjuvant and neoadjuvant treatment.

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References

  • Moertel CG, Fleming TR, Macdonald JS, et al. Levamisole and fluorouracil for adjuvant therapy of resected colon carcinoma. N Engl J Med 1990;322:352–8

    Article  CAS  PubMed  Google Scholar 

  • Haller DG, Catalano PJ, Macdonald JS, et al. Phase III study of fluorouracil, leucovorin, and levamisole in high-risk stage II and III colon cancer: final report of Intergroup 0089. J Clin Oncol 2005;23:8671–8

    Article  PubMed  Google Scholar 

  • Twelves C, Wong A, Nowacki MP, et al. Capecitabine as adjuvant treatment for stage III colon cancer. N Engl J Med 2005;352:2696–704

    Article  CAS  PubMed  Google Scholar 

  • Andre T, Boni C, Mounedji-Boudiaf L, et al. Oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment for colon cancer. N Engl J Med 2004;350:2343–51

    Article  CAS  PubMed  Google Scholar 

  • Andre T, Boni C, Navarro M, et al. Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage II or III colon cancer in the MOSAIC trial. J Clin Oncol 2009;27:3109–16

    Article  CAS  PubMed  Google Scholar 

  • Kuebler JP, Wieand HS, O'Connell MJ, et al. 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 2007;25:2198–204

    Article  CAS  PubMed  Google Scholar 

  • Schmoll HJ, Cartwright T, Tabernero J, et al. Phase III trial of capecitabine plus oxaliplatin as adjuvant therapy for stage III colon cancer: a planned safety analysis in 1,864 patients. J Clin Oncol 2007;25:102–9

    Article  CAS  PubMed  Google Scholar 

  • Saltz LB, Niedzwiecki D, Hollis D, et al. Irinotecan fluorouracil plus leucovorin is not superior to fluorouracil plus leucovorin alone as adjuvant treatment for stage III colon cancer: results of CALGB 89803. J Clin Oncol 2007;25:3456–61

    Article  CAS  PubMed  Google Scholar 

  • van Cutsem E, Labianca R, Bodoky G, et al. Randomized phase III trial comparing biweekly infusional fluorouracil/leucovorin alone or with irinotecan in the adjuvant treatment of stage III colon cancer: PETACC-3. J Clin Oncol 2009;27:3117–25

    Article  CAS  PubMed  Google Scholar 

  • Colucci G, Gebbia V, Paoletti G, et al. Phase III randomized trial of FOLFIRI versus FOLFOX4 in the treatment of advanced colorectal cancer: a multicenter study of the Gruppo Oncologico Dell'Italia Meridionale. J Clin Oncol 2005;23:4866–75

    Article  CAS  PubMed  Google Scholar 

  • Gray R, Barnwell J, McConkey C, et al. Adjuvant chemotherapy versus observation in patients with colorectal cancer: a randomised study. Lancet 2007;370:2020–9

    Article  PubMed  Google Scholar 

  • Vilar E, Gruber SB. Microsatellite instability in colorectal cancer-the stable evidence. Nat Rev Clin Oncol 2010;7:153–62

    Article  CAS  PubMed  Google Scholar 

  • Jackson McCleary NA, Meyerhardt J, Sargent D. Impact of older age on the efficacy of newer adjuvant therapies in >12,500 patients (pts) with stage II/III colon cancer: findings from the ACCENT Database. J Clin Oncol 2009;27:15s

    Article  Google Scholar 

  • Okines A, Cunningham D. Current perspective: bevacizumab in colorectal cancer – a time for reappraisal? Eur J Cancer 2009;45:2452–61

    Article  CAS  PubMed  Google Scholar 

  • Wolmark N, Yothers G, Allegra CJ. A phase III trial comparing mFOLFOX6 to mFOLFOX6 plus bevacizumab in stage II or III carcinoma of the colon: results of NSABP protocol C-08. J Clin Oncol 2009;27:18s

    Article  Google Scholar 

  • Sauer R, Becker H, Hohenberger W, et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med 2004;351:1731–40

    Article  CAS  PubMed  Google Scholar 

  • Smalley SR, Benedetti JK, Williamson SK, et al. Phase III trial of fluorouracil-based chemotherapy regimens plus radiotherapy in postoperative adjuvant rectal cancer: GI INT 0144. J Clin Oncol 2006;24:3542–7

    Article  CAS  PubMed  Google Scholar 

  • Hofheinz R, Wenz F, Post S, et al. Capecitabine (Cape) versus 5-fluorouracil (5-FU)-based (neo-)adjuvant chemoradiotherapy (CRT) for locally advanced rectal cancer (LARC): safety results of a randomized, phase III trial. J Clin Oncol 2009;27:15s

    Article  Google Scholar 

  • Aschele C, Pinto C, Cionini L. Preoperative fluorouracil (FU)-based chemoradiation with and without weekly oxaliplatin in locally advanced rectal cancer: pathologic response analysis of the Studio Terapia Adiuvante Retto (STAR)-01 randomized phase III trial. J Clin Oncol 2009;27:18s

    Article  Google Scholar 

  • Gerard J, Azria D, Montoto-Grillot C. Randomized multicenter phase III trial comparing two neoadjuvant chemoradiotherapy (CT-RT) regimens (RT45-Cap versus RT50-Capox) in patients (pts) with locally advanced rectal cancer (LARC): results of the ACCORD 12/0405 PRODIGE 2. J Clin Oncol 2009;27:18s

    Article  Google Scholar 

  • Bosset JF, Collette L, Calais G, et al. Chemotherapy with preoperative radiotherapy in rectal cancer. N Engl J Med 2006;355:1114–23

    Article  CAS  PubMed  Google Scholar 

  • Bujko K, Nowacki MP, Nasierowska-Guttmejer A, et al. Sphincter preservation following preoperative radiotherapy for rectal cancer: report of a randomised trial comparing short-term radiotherapy vs. conventionally fractionated radiochemotherapy. Radiother Oncol 2004;72:15–24

    Article  CAS  PubMed  Google Scholar 

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Correspondence to F. Gieseler.

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Jacobi, N., Gieseler, F. Adjuvant and neoadjuvant therapy in colorectal cancer. Eur Surg 42, 283–286 (2010). https://doi.org/10.1007/s10353-010-0568-4

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