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Therapie des metastasierten kolorektalen Karzinoms

Treatment of advanced colorectal cancer

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Zusammenfassung

Die Behandlung des metastasierten kolorektalen Karzinoms (KRK) hat sich in den letzten Jahren entscheidend gewandelt und wird zunehmend zur individualisierten Therapie. Seit wenigen Jahren stehen neben einer Reihe von hochwirksamen Chemotherapeutika monoklonale Antikörper für die Behandlung zur Verfügung. Mittlerweile hängt die Entscheidung über die Art und Dauer der Therapie stark davon ab, welches Ausmaß die Erkrankung hat und ob der Patient symptomatisch ist. Auch das Vorliegen bestimmter genetischer Veränderungen beeinflusst die Wahl der Substanz. Therapieziel in der palliativen Situation bleibt die Verlängerung des Überlebens und eine Verbesserung der Lebensqualität. Bei der Patientengruppe, die primär nicht resektable Lebermetastasen aufweist, die durch Verkleinerung resezierbar werden können, kann durch eine intensive neoadjuvante Therapie sekundär die Möglichkeit der chirurgischen Entfernung der Tumormanifestationen herbeigeführt und die Patienten können so potenziell geheilt werden.

Abstract

Treatment of advanced colorectal carcinoma (aCRC) has changed considerably over the past few years and is becoming increasingly individualized. In addition to highly effective chemotherapeutics, monoclonal antibodies became available for treating CRC a few years ago. The decision as to the type and duration of treatment now heavily depends on the extent of the disease and whether the patient is symptomatic. The existence of certain genetic changes also affects the choice of substance. The aim of palliative treatment remains to extend the patient’s life and to improve quality of life. In a patient group with primarily non-resectable liver metastases that may become resectable following a reduction in size, intensive neoadjuvant therapy can create the option of secondary surgical removal of the tumor manifestations and thus potentially cure the patients.

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehungen hin: Unterstützung klinischer Forschung sowie Referententätigkeit von Roche Pharma, Sanofi-Aventis und Amgen.

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  1. Knappschaftskrankenhaus, Medizinische Universitätsklinik, In der Schornau 23–25, 44892, Bochum, Deutschland

    A. Reinacher-Schick

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Reinacher-Schick, A. Therapie des metastasierten kolorektalen Karzinoms. Gastroenterologe 3, 135–143 (2008). https://doi.org/10.1007/s11377-008-0169-y

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