[Principles of neoadjuvant therapy].
Neoadjuvant therapy is now an integral part in the treatment of locally advanced cancer of the esophagus and stomach. The mechanisms of action comprise downsizing of the primary tumor, improvement of the T and N categories and the earliest possible eradication of micrometastases. Several controlled clinical studies could show that these principles can indeed augment the rate of curative (R0) resections and can reduce the likelihood of systemic recurrences. As a consequence overall survival is improved by neoadjuvant therapy. This article summarizes how the basic principles of neoadjuvant therapy translate into clinical practice and gives a review of current developmental perspectives in this field.
Lordick
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Medizinische Klinik III, Innere Medizin, Hämatologie und Onkologie, Klinikum Braunschweig, Celler Strasse 38, 38114, Braunschweig, Deutschland. medklinik3@klinikum-braunschweig.de
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D016629:Esophagectomy; D005743:Gastrectomy; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D009367:Neoplasm Staging; D011379:Prognosis