Adjuvante Therapiestrategien beim Kolonkarzinom

Zusammenfassung.

Das Kolonkarzinom ist in den industrialisierten Ländern eine der Hauptursachen der tumorbedingten Sterblichkeit. Obwohl bei 70 - 80 % der Patienten eine kurative Resektion möglich ist, liegt die 5-Jahres Überlebensrate aller Stadien nur bei 50 - 60 %. In den letzten 10 Jahren konnte durch intensive klinische Forschung der Stellenwert einer adjuvanten Therapie des Kolonkarzinoms etabliert und systematisch weiterentwickelt werden. Wie in der palliativen Therapie des Kolonkarzinoms basiert auch die adjuvante Therapie weitgehend auf 5-Fluorouracil (5-FU). Nach anfänglicher Kombination mit Levamisol hat sich inzwischen die 6-monatige Kombination mit Folinsäure als Standard etabliert. Aktuelle Therapieansätze liegen in der Immuntherapie mit monoklonalen Antikörpern, der spezifischen Tumorvakzinierung, sowie in der Verwendung neuer, in der palliativen Therapie bereits etablierter Substanzen wie Irinotecan oder Oxaliplatin. Nur durch die konsequente Fortführung multizentrischer Studien ist eine erfolgreiche Weiterentwicklung der adjuvanten Therapie und damit eine Verbesserung der Heilungschancen des Kolonkarzinoms möglich.

Adjuvant therapy strategies for colon cancer.

Colon Cancer is one of the leading causes for cancer related death in the industrialized countries. The 5 year overall survival rate is only 50 - 60 %, although 70 - 80 % of the patients are potentially cured by surgical resection. During the last 10 years intensive clinical studies helped to establish the value of adjuvant therapy for colon cancer. As in palliative therapy 5-FU was the cornerstone for adjuvant therapy. After initial combination with levamisole recent studies have established the combination of 5-FU and leukovorin over a 6 months period as standard therapy. New approaches include immune therapy with monoclonal antibodies or specific tumor vaccination as well as the study of new substances like irinotecan or oxaliplatin which have already proven to be effective in the palliative situation. Further development of adjuvant therapy for colon cancer will depend on the continued effort to support cooperative multicenter studies. Improvement in adjuvant therapy will ultimately lead to improved survival for patients suffering from colon cancer.

Schlüsselwörter:

Kolonkarzinom - Adjuvante Therapie - Chemotherapie

Key words:

Colon cancer - Adjuvant therapy - Chemotherapy

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