Erschienen in:
01.10.2006
Chemotherapy and Regional Therapy of Hepatic Colorectal Metastases: Expert Consensus Statement
verfasst von:
David L. Bartlett, MD, Jordan Berlin, MD, Gregory Y. Lauwers, MD, Wells A. Messersmith, MD, Nicholas J. Petrelli, MD, Alan P. Venook, MD
Erschienen in:
Annals of Surgical Oncology
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Ausgabe 10/2006
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Excerpt
The treatment of metastatic colorectal cancer has evolved significantly over recent years. Where once only 5-fluorouracil (5-FU) was available for treatment, there are now five active agents available for the treatment of advanced disease. Two new chemotherapy agents are now available: oxaliplatin and irinotecan. When added to either bolus or infusional 5-FU, irinotecan significantly increased the survival of colorectal cancer patients compared to those given 5-FU alone.
1,
2 When oxaliplatin plus infusional 5-FU (FOLFOX) was compared to irinotecan plus bolus 5-FU (IFL), both the response rate and survival were improved in the oxaliplatin-containing arm.
3 However, two randomized trials have shown that when 5-FU is administered by the same schedule in each arm, survival is similar in both the irinotecan- and oxaliplatin-containing arms.
4,
5 Therefore, treatment decisions for first-line therapy can be made based on the toxicity profile of individual drugs or on personal preference but not because of significant differences in efficacy. Both FOLFOX and irinotecan have demonstrated efficacy as second-line therapy.
6,
7 …