Hofheinz R-D, Stintzing S
TagesTherapieZentrum, Interdisziplinäres Tumorzentrum, Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland.
Medizinische Klinik mit Schwerpunkt Hämatologie, Onkologie und Tumorimmunologie (CCM), Charité - Universitätsmedizin Berlin, Berlin, Deutschland.
Internist (Berl). 2020 Jul;61(7):699-710. doi: 10.1007/s00108-020-00808-x.
This article deals with the treatment of metastatic colorectal cancer (stage IV). The treatment goals and approaches are determined by the resectability status of the metastases: resectable liver and lung metastases are primarily resected and perioperative chemotherapy appears to be dispensable. In potentially resectable metastases, a conversion therapy is attempted to enable a potentially curative resection. In the case of nonresectability the treatment goal is palliative. Induction and maintenance therapy as well as drug holidays are suggested in an attempt to achieve extended survival while maintaining the quality of life, beginning with the best possible individual treatment. For some patients with stage IV, molecular targeted therapies are available. The study situation and approval status are dealt with in detail. With improved molecular characterization of tumors the treatment can be further individualized.
本文论述转移性结直肠癌（IV期）的治疗。治疗目标和方法取决于转移灶的可切除性：可切除的肝和肺转移灶主要进行切除，围手术期化疗似乎并非必需。对于潜在可切除的转移灶，尝试进行转化治疗以实现可能的根治性切除。在不可切除的情况下，治疗目标是姑息性的。建议进行诱导和维持治疗以及药物假期，以期在维持生活质量的同时延长生存期，从尽可能最佳的个体化治疗开始。对于一些IV期患者，可采用分子靶向治疗。详细讨论了研究现状和获批情况。随着肿瘤分子特征的改善，治疗可进一步个体化。
