Punt C J A
Universitair Medisch Centrum St Radboud, afd. Medische Oncologie, Postbus 9101, 6500 HB Nijmegen.
Ned Tijdschr Geneeskd. 2005 Jun 25;149(26):1441-7.
Colorectal cancer is a frequently occurring malignancy in the western world. In the Netherlands, there are more than 9000 new patients annually. Approximately half of the patients die of their disease within 5 years. In 2004, several therapeutic studies were presented, the results of which may have a positive impact on the prognosis of a large proportion of patients. This concerns the adjuvant treatment of stage II and III colon carcinoma and the palliative systemic treatment of distant metastases of colorectal carcinoma. In stage II colon carcinoma, the absolute benefit of adjuvant treatment is 3-4%. This must be balanced against the burden of such treatment. Adjuvant treatment with fluorouracil-folinic acid-oxaliplatin is indicated in stage III colon carcinoma and should be considered for patients with stage II colon cancer in whom the prognosis is unfavourable. For patients for whom treatment with fluorouracil-folinic acid-oxaliplatin does not seem suitable, adjuvant treatment with capecitabine is indicated. Treatment with bevacizumab, a monoclonal antibody against vascular endothelial growth factor, in combination with chemotherapy is considered to be standard practice in first-line treatment. Together with the expected rise in the incidence of colorectal cancer, these developments will have a significant impact on healthcare, both in terms of organization and budget.
结直肠癌是西方世界常见的恶性肿瘤。在荷兰，每年有超过9000名新患者。大约一半的患者在5年内死于该病。2004年，开展了多项治疗研究，其结果可能对很大一部分患者的预后产生积极影响。这涉及II期和III期结肠癌的辅助治疗以及结直肠癌远处转移的姑息性全身治疗。在II期结肠癌中，辅助治疗的绝对获益为3% - 4%。这必须与这种治疗的负担相权衡。氟尿嘧啶 - 亚叶酸 - 奥沙利铂辅助治疗适用于III期结肠癌，对于预后不良的II期结肠癌患者也应考虑。对于似乎不适合氟尿嘧啶 - 亚叶酸 - 奥沙利铂治疗的患者，可选用卡培他滨辅助治疗。贝伐单抗（一种抗血管内皮生长因子的单克隆抗体）联合化疗被认为是一线治疗的标准方案。随着结直肠癌发病率的预期上升，这些进展将在组织和预算方面对医疗保健产生重大影响。
