[Palliative chemotherapy and radiotherapy for metastatic colorectal cancer].
BACKGROUND
There are 3 450 new cases of colorectal cancer in Norway annually. In half of the patients, metastatic disease will evolve with time. Palliative chemo- or radiotherapy can prolong disease- and symptom control when cure is not feasible.


METHODS
This paper is based on publications retrieved from a PubMed search, the authors' knowledge of the field and on recent conference abstracts.


CONCLUSIONS
Patients with metastatic colorectal cancer should initially be considered for surgery, and judged if secondary surgery is a possibility. Palliative chemotherapy is used to increase survival and maintain quality of life. 5-FU/calsiumfolinat combined with oxaliplatin or irinotecan is usually given as first line treatment for patients below 75 years--and most of them respond. Median survival is close to two years. Bevacizumab combined with an irinotecan regimen is an alternative first line treatment. Elderly patients are judged on an individual basis. Half of the patients will receive second line therapy with the alternative chemotherapy schedule. Cetuximab combined with irinotecan is a possible third line treatment. Palliative radiotherapy is most often used for inoperable rectal cancer, local recurrences, and bone or brain metastases.
Sørbye
Halfdan
H
Kreftavdelingen Haukeland Universitetssjukehus, 5021 Bergen. halfdan.sorbye@helse-bergen.no
Braendengen
Morten
M
Balteskard
Lise
L
D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D000068258:Bevacizumab; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D000068818:Cetuximab; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary / Q000628:therapy*; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D000077146:Irinotecan; D002955:Leucovorin / Q000008:administration & dosage; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D010166:Palliative Care / Q000379:methods; D011788:Quality of Life; D015996:Survival Rate
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D000068258:Bevacizumab; D000077146:Irinotecan; D000068818:Cetuximab; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin