Pavy J J, Schraub S
Service de radiothérapie-oncologie, CHU Jean-Minjoz, Besançon.
Rev Prat. 1997 Jun 15;47(12 Spec No):S43-6.
Treatments of colorectal cancers can still be curative up to fairly advanced stage. Clinical situations vary greatly depending on the primary: local recurrence is a major event in rectal cancer whereas metastases are the main problem in colon cancer. Therefore, rectal cancer benefit from locoregional combined treatments, chemotherapy, radiotherapy and surgery, to control the pelvic disease. In the metastatic setting, it is important to offer potentially curative treatment as often as possible. Radiotherapy for bone or brain metastasis is well known and frequently used; irradiation of painful liver metastasis is less regularly discussed despite its efficacy. Symptomatic treatments like analgesics narcotic or not, non steroidal anti-inflammatory, anxiolytics, etc. are useful. All these treatments must be evaluated, not only in term of anti-tumoural but also from the quality of life point of view.
结直肠癌在相当晚期的阶段仍可通过治疗治愈。临床情况因原发部位而异:局部复发是直肠癌的主要问题,而转移是结肠癌的主要问题。因此,直肠癌受益于局部区域联合治疗、化疗、放疗和手术,以控制盆腔疾病。在转移的情况下,尽可能提供潜在的治愈性治疗很重要。骨或脑转移的放射治疗众所周知且经常使用;尽管其疗效显著,但对疼痛性肝转移的照射较少被常规讨论。对症治疗,如使用或不使用麻醉性镇痛药、非甾体抗炎药、抗焦虑药等,是有用的。所有这些治疗不仅必须从抗肿瘤的角度进行评估,还必须从生活质量的角度进行评估。