title: [Palliative chemotherapy for colorectal cancer--current state, significance, trends].
abstract: BACKGROUND
  There are a number of effective substances available for palliative treatment of colorectal cancer, contributing to a considerable extension of the median survival time either purely medically or by increasing the chance of secondary resectability through improved effectiveness of the administered drugs. PATIENTS / MATERIAL: Defining treatment depending on predominant patient characteristics remains crucial for any therapeutic success. This requires interdisciplinary co-ordination within tumour boards.
  
  
  METHODS
  In aggressive tumours a therapeutic approach inducing high response rates is favoured, usually including a triple or quadruple combination incl. antibodies. In cases of slow tumour progress and limited patient profile, a sequence of chemotherapy is chosen. Implementing and integrating locally ablative modes of therapy into the treatment strategy can increase the effectiveness additionally. In a best case scenario additional systemic side effects can be avoided resulting in a not insignificant benefit in quality of life.
  
  
  RESULTS
  Further genotyping beyond the K-RAS state is necessary to make predictive and prognostic statements concerning the drugs applied and to avoid ineffectiveness.
  
  
  CONCLUSIONS
  Considerable progress has been achieved in the medical therapy for metastasised colorectal cancer. The targeted application of already available as well as recently developed substances requires further evaluation by appropriate studies.
authors.affiliation: Otto-von-Guericke-Universität, Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Magdeburg, Deutschland. patrick.stuebs@med.ovgu.de
authors.forename: P
authors.initials: P
authors.lastname: Stübs
authors.forename: P
authors.initials: P
authors.lastname: Habermann
authors.forename: C
authors.initials: C
authors.lastname: Wex
authors.forename: M
authors.initials: M
authors.lastname: Mohren
authors.forename: K
authors.initials: K
authors.lastname: Zierau
authors.forename: H
authors.initials: H
authors.lastname: Lippert
authors.forename: J
authors.initials: J
authors.lastname: Fahlke
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology / Q000601:surgery; D003131:Combined Modality Therapy; D004252:DNA Mutational Analysis; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D005838:Genotype; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000556:secondary; D009367:Neoplasm Staging; D010166:Palliative Care / Q000379:methods* / Q000639:trends; D011379:Prognosis; D011518:Proto-Oncogene Proteins / Q000235:genetics; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics; D016283:Proto-Oncogene Proteins p21(ras); D015996:Survival Rate; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D018631:ras Proteins / Q000235:genetics
chemical_list: C117307:KRAS protein, human; D011518:Proto-Oncogene Proteins; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; C512478:EGFR protein, human; D066246:ErbB Receptors; C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins