Avtor/Urednik     Štabuc, Borut
Naslov     Systemic therapy for colorectal cancer
Tip     članek
Vir     Arch Oncol
Vol. in št.     Letnik 11, št. 4
Leto izdaje     2003
Obseg     str. 255-63
Jezik     eng
Abstrakt     Colorectal cancer alone accounts for around 200, 000 deaths in Europe and represents a significant health problem. Although about fifty percent of patients are cured by surgery alone, the other half will eventually die due to metastatic disease, which includes approximately 25% of patients who have evidence of metastases at the time of diagnosis. Surgical resection of the primary tumor and regional lymph nodes is the only curative therapy for colorectal cancer. However, adjuvant chemotherapy in stage III for colon cancer following curative resection has been shown to reduce the risk of recurrence by 1940% and of death by 16-33%. Today, 5-fluorouracil and leucovorin given for six monfhs may represent the best adjuvant treatment available The contribution of levamisole to adjuvant treatment seems to be marginal, if any. The benefit of adjuvant chemotherapy for the patients with Dukes 8 colon cancer is less clear. A meta-analysis of 1,381 patients with advanced colorectal cancer showed a significant increase in response rate with the bolus 5-fluorouracil and leucovorin versus 5-fluorouracil alone, but no significant difference in median survival. Continuous infusion allows higher doses of 5-FU than rapid bolus infusion and improves response rate, survival and time to progression. Oral fluoropyrimidines (capecitabine and uracil/tegafur (UFTJ) are as active as intravenous fluoropyrimidines. Compared to intravenous SFU, oral fluoropyrimidines have safety advantages, clinical benefits, and are more convenient for patients. Phase III randomized clinical trials in patients with metastatic colorectal cancer demonstrate the significant superiority of combining irinotecan with 5-fluorouracil and leucovorin or oxaliplatin with 5-fluorouracil and leucovorin over the same 5-fluorouracil and leucovorin alone. (Abstract truncated at 2000 characters).
Deskriptorji     COLORECTAL NEOPLASMS
CHEMOTHERAPY, ADJUVANT
FLUOROURACIL
LEUCOVORIN
INTERFERON-ALPHA
TEGAFUR
LEVAMISOLE
NEOPLASM METASTASIS
NEOPLASM STAGING
ANTIBODIES, MONOCLONAL
PLATINUM COMPOUNDS
CAMPTOTHECIN