Senellart Hélène, Hiret Sandrine, Guerin-Meyer Véronique, Bennouna Jaafar
Service d'oncologie médicale de l'Institut de cancérologie de l'Ouest, site R.-Gauducheau, boulevard Jacques-Monod, 44805 Nantes Saint-Herblain cedex, France.
Service d'oncologie médicale de l'Institut de cancérologie de l'Ouest, 2, rue Moll, 49933 Angers cedex 9, France.
Bull Cancer. 2014 Jun;101(6):619-25. doi: 10.1684/bdc.2014.1984.
Management of unresectable metastatic colorectal cancer dramatically changed over the past 20 years. News standards of care combine cytotoxic drugs like fluoropyrimidines, irinotecan and oxaliplatin, with targeted therapies such as anti-EGFR monoclonal antibodies and anti-angiogenic agents. Survival benefit results from these new options but correlates with more exposure to chemotherapy and cumulative toxicities. The main concern for these patients remains to find the optimal balance between efficacy, toxicity and quality of life. This article reviewed the main studies designed to evaluate the concept of maintenance therapy after induction chemotherapy and discontinuation strategy. Available therapeutic standards and options to shorten duration of chemotherapy and reduce toxicities are reported and discussed.
在过去20年中,不可切除转移性结直肠癌的管理发生了巨大变化。新的护理标准将氟嘧啶、伊立替康和奥沙利铂等细胞毒性药物与抗表皮生长因子受体(EGFR)单克隆抗体和抗血管生成药物等靶向治疗相结合。这些新疗法带来了生存获益,但也意味着更多的化疗暴露和累积毒性。这些患者的主要关注点仍然是在疗效、毒性和生活质量之间找到最佳平衡。本文回顾了旨在评估诱导化疗后维持治疗概念和停药策略的主要研究。报告并讨论了可用于缩短化疗疗程和降低毒性的现有治疗标准及选择。