title: [New therapeutic options in chemotherapy of advanced colorectal cancer].
abstract: BACKGROUND
  Chemotherapeutic options in the treatment of advanced colorectal cancer have markedly improved during the last years. This is partly due to the high-dose 5-FU regimen, but also to the development of new cytotoxic agents and drug combinations.
  
  
  RESULTS
  High-dose 5-FU, irinotecan, and oxaliplatin seem to be superior to low-dose 5-FU in terms of response rate and disease control. Combination of irinotecan with 5-FU/FA showed significant longer overall survival rates compared to 5-FU/FA alone in both published phase III trials. Today most patients are treated by a sequential therapeutic concept using the newer drugs mainly for second or third line therapy. However, there are reasons for the use of more intensive chemotherapy combinations in first line treatment. Combination of oxaliplatin with 5-FU/FA, that failed improvement of overall survival compared to 5-FU/FA alone, could downstage previously unresectable liver metastases for potentially curative surgery in some patients. Oral fluoropyrimidines mark another progress in the treatment of advanced colorectal cancer. They seem to be comparable to low-dose 5-FU/FA and could ease chemotherapy.
  
  
  CONCLUSIONS
  Prospective randomized phase III trials must confirm the best chemotherapy and the best strategy for the different subgroup of patients.
authors.affiliation: Medizinische Poliklinik, Universität Würzburg. p.reimer@medizin.uni-wuerzburg.de
authors.forename: P
authors.initials: P
authors.lastname: Reimer
authors.forename: H
authors.initials: H
authors.lastname: Rückle-Lanz
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000494:pharmacology / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000069287:Capecitabine; D002277:Carcinoma / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D018572:Disease-Free Survival; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D000077146:Irinotecan; D002955:Leucovorin / Q000008:administration & dosage; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D011799:Quinazolines / Q000008:administration & dosage; D005641:Tegafur / Q000008:administration & dosage; D013876:Thiophenes / Q000008:administration & dosage; D014498:Uracil / Q000008:administration & dosage / Q000031:analogs & derivatives
chemical_list: D009944:Organoplatinum Compounds; D011799:Quinazolines; D013876:Thiophenes; D000077150:Oxaliplatin; D003841:Deoxycytidine; D005641:Tegafur; D014498:Uracil; D000069287:Capecitabine; D000077146:Irinotecan; C068874:raltitrexed; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin