Skip to main content
Erschienen in:

01.07.2007 | Leitthema

Symptomkontrollierende Effekte der Chemotherapie

Ergänzung palliativer Therapiekonzepte?

verfasst von: Dr. B. Alt-Epping, W. Jung, F. Nauck

Erschienen in: Die Onkologie | Ausgabe 7/2007

Einloggen, um Zugang zu erhalten

Zusammenfassung

In therapiebezogenen Entscheidungssituationen bei Patienten mit weit fortgeschrittenem Tumorleiden stehen Maßnahmen mit dem Ziel der bestmöglichen Symptomkontrolle und Lebensqualität im Vordergrund. Jedoch rücken erst seit Mitte der 1990er Jahre symptomkontrollierende Effekte zytotoxischer Chemotherapeutika ins Blickfeld klinischer Studien. Die besonderen Eigenschaften von sog. „targeted therapies“ werfen ein weiteres, neues Licht auf Intention und Erfolgskriterien von Tumortherapien. Der folgende Beitrag beschreibt nachgewiesene symptomkontrollierende Effekte von chemotherapeutischen und anderen tumormodifizierenden Substanzen bei einer Auswahl solider Tumoren und versucht, deren Stellenwert sowohl in der palliativen Onkologie als auch in der Palliativmedizin zu definieren.
Literatur
1.
Zurück zum Zitat IQWiG Herbstsymposion 24./25.11.2005 Köln; www.iqwig.de/download/Adler.pdf IQWiG Herbstsymposion 24./25.11.2005 Köln; www.iqwig.de/download/Adler.pdf
2.
Zurück zum Zitat Ellis PA et al. (1995) Symptom relief with MVP chemotherapy in advanced non-small cell lung cancer. Br J Cancer 71: 366–370PubMed Ellis PA et al. (1995) Symptom relief with MVP chemotherapy in advanced non-small cell lung cancer. Br J Cancer 71: 366–370PubMed
3.
Zurück zum Zitat Tummarello D et al. (1995) Symptomatic, stage IV, non-small cell lung cancer: response, toxicity, performance status change and symptom relief in patients treated with cisplatin, vinblastine and mitomycinC. Cancer Chemother Pharmacol 35: 249–253 PubMedCrossRef Tummarello D et al. (1995) Symptomatic, stage IV, non-small cell lung cancer: response, toxicity, performance status change and symptom relief in patients treated with cisplatin, vinblastine and mitomycinC. Cancer Chemother Pharmacol 35: 249–253 PubMedCrossRef
4.
Zurück zum Zitat Adelstein DJ (1995) Palliative chemotherapy for non-small cell lung cancer. Semin Oncol (2 Suppl 3) 22: 35–39 Adelstein DJ (1995) Palliative chemotherapy for non-small cell lung cancer. Semin Oncol (2 Suppl 3) 22: 35–39
5.
Zurück zum Zitat Hansen HH (1995) Is there a role for chemotherapy of non-small cell lung cancer? Ann Oncol (Suppl 1) 6: 79–82 Hansen HH (1995) Is there a role for chemotherapy of non-small cell lung cancer? Ann Oncol (Suppl 1) 6: 79–82
6.
Zurück zum Zitat Klastersky J (1995) Therapy of non-small cell lung cancer. Lung Cancer (Suppl 1) 12:S133–S145 Klastersky J (1995) Therapy of non-small cell lung cancer. Lung Cancer (Suppl 1) 12:S133–S145
7.
Zurück zum Zitat Nicum S, Cullen MH (2000) Chemotherapy versus palliative care in non-small cell lung cancer. Anticancer Drugs 11: 603–607PubMedCrossRef Nicum S, Cullen MH (2000) Chemotherapy versus palliative care in non-small cell lung cancer. Anticancer Drugs 11: 603–607PubMedCrossRef
8.
Zurück zum Zitat Smith IE (1995) Medical management of non-small cell lung cancer. Eur J Cancer 31A: 818–819PubMedCrossRef Smith IE (1995) Medical management of non-small cell lung cancer. Eur J Cancer 31A: 818–819PubMedCrossRef
9.
Zurück zum Zitat Hickish TF, Smith IE, Ashley S et al. (1995) Chemotherapy for elderly patients with lung cancer. Lancet 346: 580PubMedCrossRef Hickish TF, Smith IE, Ashley S et al. (1995) Chemotherapy for elderly patients with lung cancer. Lancet 346: 580PubMedCrossRef
10.
Zurück zum Zitat Gridelli C (2002) Does chemotherapy have a role as palliative therapy for unfit or elderly patients with non-small cell lung cancer? Lung Cancer (Suppl 2) 38: S45–S50 Gridelli C (2002) Does chemotherapy have a role as palliative therapy for unfit or elderly patients with non-small cell lung cancer? Lung Cancer (Suppl 2) 38: S45–S50
11.
Zurück zum Zitat Gridelli C et al. (2003) Gemcitabine plus vinorelbine compared with cisplatin plus vinorelbine or cisplatin plus gemcitabine for advanced non-small cell lung cancer: a phase III trial of the Italian GEMVIN investigators and the National Cancer Institute of Canada clinical trials group. J Clin Oncol 21: 3025–3034PubMedCrossRef Gridelli C et al. (2003) Gemcitabine plus vinorelbine compared with cisplatin plus vinorelbine or cisplatin plus gemcitabine for advanced non-small cell lung cancer: a phase III trial of the Italian GEMVIN investigators and the National Cancer Institute of Canada clinical trials group. J Clin Oncol 21: 3025–3034PubMedCrossRef
12.
Zurück zum Zitat Anderson H et al. (2000) Gemcitabine plus best supportive care (BSC) vs BSC in inoperable non-small cell lung cancer – a randomized trial with quality of life as the primary outcome. Br J Cancer 83: 447–453PubMedCrossRef Anderson H et al. (2000) Gemcitabine plus best supportive care (BSC) vs BSC in inoperable non-small cell lung cancer – a randomized trial with quality of life as the primary outcome. Br J Cancer 83: 447–453PubMedCrossRef
13.
Zurück zum Zitat Shepherd F, Dancey J, Ramlau R et al. (2000) Prospective randomized trial of docetaxel versus best supportive care in patients with non-small-cell lung cancer previously treated with platinum-based chemotherapy. J Clin Oncol 18: 2095–2103PubMed Shepherd F, Dancey J, Ramlau R et al. (2000) Prospective randomized trial of docetaxel versus best supportive care in patients with non-small-cell lung cancer previously treated with platinum-based chemotherapy. J Clin Oncol 18: 2095–2103PubMed
14.
Zurück zum Zitat Hanna N et al. (2004) Randomized phase III trial of pemetrexed versus docetaxel in patients with non-small-cell lung cancer previously treated with chemotherrapy. J Clin Oncol 22: 1589–1597 PubMedCrossRef Hanna N et al. (2004) Randomized phase III trial of pemetrexed versus docetaxel in patients with non-small-cell lung cancer previously treated with chemotherrapy. J Clin Oncol 22: 1589–1597 PubMedCrossRef
15.
Zurück zum Zitat Gralla RJ et al. (2003) Improving quality of life in patients with malignant pleural mesothelioma: results of the randomitzed pemetrexed + cisplatin vs. cisplatin trial using the LCSS-meso instrument. Proc Am Soc Clin Oncol 22: 621; abstr. # 2496 Gralla RJ et al. (2003) Improving quality of life in patients with malignant pleural mesothelioma: results of the randomitzed pemetrexed + cisplatin vs. cisplatin trial using the LCSS-meso instrument. Proc Am Soc Clin Oncol 22: 621; abstr. # 2496
16.
Zurück zum Zitat Vogelzang NJ et al. (2003) Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma. J Clin Oncol 21: 2636–2644PubMedCrossRef Vogelzang NJ et al. (2003) Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma. J Clin Oncol 21: 2636–2644PubMedCrossRef
17.
Zurück zum Zitat O’Brien M et al. (2005) Survival benefit of oral topotecan plus supportive care versus supportive care alone in relapsed, resistant SCLC. Lung Cancer (Suppl 2) 49: S54 O’Brien M et al. (2005) Survival benefit of oral topotecan plus supportive care versus supportive care alone in relapsed, resistant SCLC. Lung Cancer (Suppl 2) 49: S54
18.
Zurück zum Zitat O’Brien M et al. (2006) Phase III trial comparing supportive care alone with supportive care with oral topotecan in patients with relapsed small cell lung cancer. J Clin Oncol 24: 5441–5447CrossRef O’Brien M et al. (2006) Phase III trial comparing supportive care alone with supportive care with oral topotecan in patients with relapsed small cell lung cancer. J Clin Oncol 24: 5441–5447CrossRef
19.
Zurück zum Zitat Pawel J et al. (1999) Topotecan versus cyclophosphamide, doxorubicin and vincristine for the treatment of recurrent small-cell lung cancer. J Clin Oncol 17: 658–667 Pawel J et al. (1999) Topotecan versus cyclophosphamide, doxorubicin and vincristine for the treatment of recurrent small-cell lung cancer. J Clin Oncol 17: 658–667
20.
Zurück zum Zitat Tannock IF, Osoba D, Stockler MR et al. (1996) Chemotherapy with mitoxantrone plus prednisone or prednisone alone for symptomatic hormone-resistant prostate cancer. A Canadian randomized trial with palliative end points. J Clin Oncol 14: 1756–1764PubMed Tannock IF, Osoba D, Stockler MR et al. (1996) Chemotherapy with mitoxantrone plus prednisone or prednisone alone for symptomatic hormone-resistant prostate cancer. A Canadian randomized trial with palliative end points. J Clin Oncol 14: 1756–1764PubMed
21.
Zurück zum Zitat Berry DL et al. (2006) Quality of life and pain in advanced stage prostate cancer: results of a Southwest Oncology Group randomized trial comparing docetaxel and estramustine to mitoxantrone and prednisone. J Clin Oncol 24: 2828–2835PubMedCrossRef Berry DL et al. (2006) Quality of life and pain in advanced stage prostate cancer: results of a Southwest Oncology Group randomized trial comparing docetaxel and estramustine to mitoxantrone and prednisone. J Clin Oncol 24: 2828–2835PubMedCrossRef
22.
Zurück zum Zitat Tannock IF, deWit R, Berry WR et al. (2004) Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. N Eng J Med 351: 1502–1512CrossRef Tannock IF, deWit R, Berry WR et al. (2004) Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. N Eng J Med 351: 1502–1512CrossRef
23.
Zurück zum Zitat Burris H et al. (1997) Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial. J Clin Oncol 15: 2403–2413PubMed Burris H et al. (1997) Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial. J Clin Oncol 15: 2403–2413PubMed
24.
Zurück zum Zitat Burris H, Storniolo AM (1997) Assessing clinical benefit in the treatment of pancreas cancer: gemcitabine compared to 5-fluorouracil. Eur J Cancer (Suppl 1) 33: S18–S22 Burris H, Storniolo AM (1997) Assessing clinical benefit in the treatment of pancreas cancer: gemcitabine compared to 5-fluorouracil. Eur J Cancer (Suppl 1) 33: S18–S22
25.
Zurück zum Zitat Glimelius B, Hoffmann K, Sjoden PO et al. (1996) Chemotherapy improves survival and quality of life in advanced pancreatic and biliary cancer. Ann Oncol 7: 593–600PubMed Glimelius B, Hoffmann K, Sjoden PO et al. (1996) Chemotherapy improves survival and quality of life in advanced pancreatic and biliary cancer. Ann Oncol 7: 593–600PubMed
26.
Zurück zum Zitat Caraceni A, DeDonno F (1998) Analgesic effects of chemotherapy? J Clin Oncol 16: 803PubMed Caraceni A, DeDonno F (1998) Analgesic effects of chemotherapy? J Clin Oncol 16: 803PubMed
27.
Zurück zum Zitat Aristides M et al. (2003) Economic evaluation of gemcitabine in the treatment of pancreatic cancer in the UK. Eur J Health Econom 4: 216–221CrossRef Aristides M et al. (2003) Economic evaluation of gemcitabine in the treatment of pancreatic cancer in the UK. Eur J Health Econom 4: 216–221CrossRef
28.
Zurück zum Zitat Doyle C et al. (2001) Does chemotherapy palliate? Evaluation of expectations, outcomes, and costs in women receiving chemotherapy for advanced ovarian cancer. J Clin Oncol 19: 1266–1274PubMed Doyle C et al. (2001) Does chemotherapy palliate? Evaluation of expectations, outcomes, and costs in women receiving chemotherapy for advanced ovarian cancer. J Clin Oncol 19: 1266–1274PubMed
29.
Zurück zum Zitat Kornblith A (2001) Does palliative care palliate? J Clin Oncol 19: 2111–2113PubMed Kornblith A (2001) Does palliative care palliate? J Clin Oncol 19: 2111–2113PubMed
30.
Zurück zum Zitat Shepherd FA et al. (2005) Erlotinib in previously treated non-small-cell lung cancer. N Engl J Med 353: 123–132PubMedCrossRef Shepherd FA et al. (2005) Erlotinib in previously treated non-small-cell lung cancer. N Engl J Med 353: 123–132PubMedCrossRef
31.
Zurück zum Zitat Bezjak A et al. (2006) Symptom improvement in lung cancer patients treated with erlotinib: quality of life analysis of the National Cancer Institute of Canada clinical trials group study BR.21. J Clin Oncol 24: 3831–3837PubMedCrossRef Bezjak A et al. (2006) Symptom improvement in lung cancer patients treated with erlotinib: quality of life analysis of the National Cancer Institute of Canada clinical trials group study BR.21. J Clin Oncol 24: 3831–3837PubMedCrossRef
32.
Zurück zum Zitat Kris MG, Natale RB, Herbst RS et al. (2003) Efficacy of gefitinib, an inhibitor of the epidermal growth factor receptor tyrosine kinase, in symptomatic patients with non-small cell lung cancer: a randomised trial. JAMA 290: 2149–2158PubMedCrossRef Kris MG, Natale RB, Herbst RS et al. (2003) Efficacy of gefitinib, an inhibitor of the epidermal growth factor receptor tyrosine kinase, in symptomatic patients with non-small cell lung cancer: a randomised trial. JAMA 290: 2149–2158PubMedCrossRef
33.
Zurück zum Zitat Motzer R et al. (2007) Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. N Eng J Med 356: 115–124 CrossRef Motzer R et al. (2007) Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. N Eng J Med 356: 115–124 CrossRef
34.
Zurück zum Zitat Escudier B et al. (2007) Sorafenib in advanced clear-cell renal-cell carcinoma. N Eng J Med 356: 125–134 CrossRef Escudier B et al. (2007) Sorafenib in advanced clear-cell renal-cell carcinoma. N Eng J Med 356: 125–134 CrossRef
35.
Zurück zum Zitat Schöffski P et al. (2006) Emerging role of tyrosine kinase inhibitors in the treatment of advanced renal cell cancer: a review. Ann Oncol 17: 1185–1196PubMedCrossRef Schöffski P et al. (2006) Emerging role of tyrosine kinase inhibitors in the treatment of advanced renal cell cancer: a review. Ann Oncol 17: 1185–1196PubMedCrossRef
36.
Zurück zum Zitat Geyer CE et al. (2006) Lapatinib plus capecitabine for HER2-positive advanced breast cancer. N Eng J Med 355: 2733–2743CrossRef Geyer CE et al. (2006) Lapatinib plus capecitabine for HER2-positive advanced breast cancer. N Eng J Med 355: 2733–2743CrossRef
37.
Zurück zum Zitat Lin N et al. (2006) Phase 2 trial of lapatinib for brain metastases in patients with HER2+ breast cancer. Proc ASCO 23: 3 s; abstr. # 503 Lin N et al. (2006) Phase 2 trial of lapatinib for brain metastases in patients with HER2+ breast cancer. Proc ASCO 23: 3 s; abstr. # 503
38.
Zurück zum Zitat Alt-Epping B, Nauck F (2007) A 44-year old breast cancer patient with refractory vomiting due to neoplastic meningitis: profound symptom relief by intrathecal chemotherapy. EAPC congress 2007; abstr. # 300 Alt-Epping B, Nauck F (2007) A 44-year old breast cancer patient with refractory vomiting due to neoplastic meningitis: profound symptom relief by intrathecal chemotherapy. EAPC congress 2007; abstr. # 300
39.
Zurück zum Zitat Overbeck et al. (2006) Erlotinib in advanced stage NSCLC: subgroup with major response. DGHO congress 2006; P611 Overbeck et al. (2006) Erlotinib in advanced stage NSCLC: subgroup with major response. DGHO congress 2006; P611
40.
Zurück zum Zitat Cardoso F et al. (2002) Second and subsequent lines of chemotherapy for metastatic breast cancer: what did we learn in the last two decades? Ann Oncol 13: 197–207PubMedCrossRef Cardoso F et al. (2002) Second and subsequent lines of chemotherapy for metastatic breast cancer: what did we learn in the last two decades? Ann Oncol 13: 197–207PubMedCrossRef
41.
Zurück zum Zitat Slevin M et al. (1990) Attitudes to chemotherapy: comparing views of patients with cancer with those of doctors, nurses and general public. Br Med J 300: 1458–1460 CrossRef Slevin M et al. (1990) Attitudes to chemotherapy: comparing views of patients with cancer with those of doctors, nurses and general public. Br Med J 300: 1458–1460 CrossRef
42.
Zurück zum Zitat Husebo S (2003) Sollen wir immer einen Strohhalm anbieten? In: Husebo S, Klaschik E (Hrsg) Palliativmedizin. Springer, Berlin Heidelberg, S 296–302 Husebo S (2003) Sollen wir immer einen Strohhalm anbieten? In: Husebo S, Klaschik E (Hrsg) Palliativmedizin. Springer, Berlin Heidelberg, S 296–302
44.
Zurück zum Zitat Deutsche Gesellschaft für Palliativmedizin, zitiert aus: Definition Palliativmedizin 31.10.2003. www.dgpalliativmedizin.de Deutsche Gesellschaft für Palliativmedizin, zitiert aus: Definition Palliativmedizin 31.10.2003. www.dgpalliativmedizin.de
Metadaten
Titel
Symptomkontrollierende Effekte der Chemotherapie
Ergänzung palliativer Therapiekonzepte?
verfasst von
Dr. B. Alt-Epping
W. Jung
F. Nauck
Publikationsdatum
01.07.2007
Verlag
Springer-Verlag
Erschienen in
Die Onkologie / Ausgabe 7/2007
Print ISSN: 2731-7226
Elektronische ISSN: 2731-7234
DOI
https://doi.org/10.1007/s00761-007-1215-y

Weitere Artikel der Ausgabe 7/2007

Die Onkologie  7/2007 Zur Ausgabe

Leitthema

Tumorkachexie

CME Weiterbildung • Zertifizierte Fortbildung

Carcinoma of unknown primary (CUP-Syndrom)

Neu im Fachgebiet Onkologie

Verkürzte MRT bei dichtem Brustgewebe: Was bringen sequenzielle Scans?

21.07.2024 Mamma-MRT Nachrichten

Frauen mit dichtem Brustgewebe könnten zusätzlich zum regulären Mammografie-Screening von sequenziellen MRT-Untersuchungen mit verkürztem Protokoll (AB-MRT) profitieren, schlagen US-Radiologen vor.

Informierte Frauen neigen zu späterem Mammografie-Screening

Frauen in ihren 40ern, die über die Vor- und Nachteile des Mammografie-Screenings auf Brustkrebs informiert werden, neigen stärker dazu, den Screeningbeginn nach hinten zu verschieben. Die Mehrheit aber nähme das Angebot an, wie eine US-Studie zeigt.

Endometriose-Subtypen und das Risiko für Ovarialkarzinome

19.07.2024 Ovarialkarzinom Nachrichten

US-Kohortendaten sprechen dafür, dass verschiedene Endometrioseformen unterschiedlich mit dem Risiko für Ovarialkarzinome assoziiert sind. Besonders erhöht ist das Risiko offenbar bei tief infiltrierenden und ovariellen Endometrioseformen.

Die zelluläre Differenzierung wird wiederhergestellt

18.07.2024 Akute myeloische Leukämie Nachrichten

Ivosidenib von Servier ist ein Inhibitor der mutierten Isoform der Isocitrat-Dehydrogenase-1 (IDH1) und wird zur Behandlung von Patientinnen und Patienten mit neu diagnostizierter akuter myeloischer Leukämie (AML) eingesetzt. Die Substanz sorgt für die Wiederherstellung der zellulären Differenzierung.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.