[Background and experience of adjuvant cytostatic therapy in gastrointestinal cancer (author's transl)].
Survival rates for patients with colorectal cancer have remained unchanged during the last 30 years. Every third patient with colon cancer Dukes' C and every fourth patient with rectal cancer Dukes' C survives 5 years. Of the patients who succumb to colorectal cancer, 85% will die within 3 years from diagnosis. There are many studies concerning the mechanisms of adjuvant chemotherapy. Its effectiveness has been proven in animal experiments. Micrometastases have a large growth fraction, few non-proliferative cells, and because of this, increased sensibility to cytostatics. Adjuvant chemotherapy aimed at treating occult metastases. In colorectal cancer the combination of 5-FU and Nitrosurea has been shown to have a better effect than 5-FU alone. Grage et al. have shown patients with colorectal cancer Dukes' C to have a longer tumour-free interval with adjuvant 5-FU, and this treatment gives patients with rectal cancer a prolonged survival time. In an adjuvant study, peroral 5-FU 90 days versus placebo did not show any effect. In another adjuvant study Vincristin, CCNU and 5-FU treated patients had fewer tumour recurrences than control patients. The observation time is, however, rather short. Adjuvant chemotherapy for colorectal cancer has shown promising results and it is hoped that further attempts with other forms of cancer in the gastrointestinal tract will also yield the same results.
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003110:Colonic Neoplasms / Q000473:pathology / Q000601:surgery*; D004359:Drug Therapy, Combination; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D008130:Lomustine / Q000627:therapeutic use; D009367:Neoplasm Staging; D009607:Nitrosourea Compounds / Q000627:therapeutic use; D011379:Prognosis; D011897:Random Allocation; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D014750:Vincristine / Q000627:therapeutic use
D000970:Antineoplastic Agents; D009607:Nitrosourea Compounds; D014750:Vincristine; D008130:Lomustine; D005472:Fluorouracil
Hintergründe und Erfahrungen mit der adjuvanten Zytostatiktherapie bei gastrointestinalem Karzinom.