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Viszeralchirurgie 2007; 42(5): 300-305
DOI: 10.1055/s-2007-981323
Originalarbeit

© Georg Thieme Verlag Stuttgart · New York

Chemotherapie des metastasierten Ösophagus-, Magen- und Pankreaskarzinoms

Chemotherapy for Advanced Esophageal, Gastric and Pancreatic CancerH. Oettle1 , M. Sinn1
  • 1Charité - Universitätsmedizin Berlin, CharitéCentrum für Tumormedizin, Med. Klinik m. S. Hämatologie / Onkologie
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Publication History

Publication Date:
04 October 2007 (online)

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Die Therapie des metastasierten Magen-, Ösophagus- und Pankreaskarzinoms ist in den letzten Jahren komplexer und vielfältiger geworden. Neben der systemischen Chemotherapie hat auch die Bedeutung von lokalen palliativen Verfahren zugenommen. Gemeinsam ist allen 3 Krankheitsentitäten ihre trotz intensiver Forschungsbemühungen weiterhin schlechte Prognose bei einer typischerweise frühen Metastasierung. Durch zytostatische Therapie kann in der palliativen Situation eine Verbesserung der Lebensqualität durch Tumoransprechen und damit Rückgang tumorassoziierter Symptome erreicht werden. Allerdings fehlen bisher Standardtherapien, die eine signifikante Verbesserung des Gesamtüberlebens der betroffenen Patienten zeigen konnten.

Literatur

  • 1 Ajani J, Ilson D. et al . “Paclitaxel in the treatment of carcinoma of the esophagus”.  Semin Oncol. 1995;  22 (3 Suppl 6) 35-40
    PubMedGoogle Scholar
  • 2 Ajani J, Moiseyenko V. et al . “Quality of life with docetaxel plus cisplatin and fluorouracil compared with cisplatin and fluorouracil from a phase III trial for advanced gastric or gastroesophageal adenocarcinoma: the V-325 Study Group”.  J Clin Oncol. 2007;  25 3210-3216
    CrossrefPubMedGoogle Scholar
  • 3 Bleiberg H, Conroy T. et al . “Randomised phase II study of cisplatin and 5-fluorouracil (5-FU) versus cisplatin alone in advanced squamous cell oesophageal cancer”.  Eur J Cancer. 1997;  33 1216-1220
    CrossrefPubMedGoogle Scholar
  • 4 Boeck S, Hinke A. et al . “Importance of performance status for treatment outcome in advanced pancreatic cancer”.  World J Gastroenterol. 2007;  13 224-227
    PubMedGoogle Scholar
  • 5 Brown L, Silverman D. et al . “Adenocarcinoma of the esophagus and esophagogastric junction in white men in the United States: alcohol, tobacco, and socioeconomic factors”.  Cancer Causes Control. 1994;  5 333-340
    CrossrefPubMedGoogle Scholar
  • 6 Burris H, Moore M. et al . “Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial”.  J Clin Oncol. 1997;  15 2403-2413
    CrossrefPubMedGoogle Scholar
  • 7 Burtness B, Gibson M. et al . “Phase II trial of docetaxel / irinotecan therapy in metastatic esophageal cancer: evidence for activity in previously untreated patients”.  J Clin Oncol, ASCO Annual Meeting Proceedings. 2005;  23 No. 16 S 4070
    PubMedGoogle Scholar
  • 8 Casaretto L, Sousa P. et al . “Chemotherapy versus support cancer treatment in advanced gastric cancer: a meta-analysis”.  Braz J Med Biol Res. 2006;  39 431-440 ,  Epub 2006 Apr 3
    PubMedGoogle Scholar
  • 9 Conroy T, Etienne P. et al . “Phase II trial of vinorelbine in metastatic squamous cell esophageal carcinoma. European Organization for Research and Treatment of Cancer Gastrointestinal Treat Cancer Cooperative Group”.  J Clin Oncol. 1996;  14 164-170
    PubMedGoogle Scholar
  • 10 Cunningham D. et al . “Phase III randomised comparison of Gemcitabine versus gemcitabine plus capecitabine in patients with advanced pancreatic cancer”.  Eur J Cancer. 2005;  Suppl 3 12
    PubMedGoogle Scholar
  • 11 Cunningham D, Rao S. “Randomised multicentre phase III study comparing capecitabine with fluorouracil and oxaliplatin with cisplatin in patients with advanced oesophagogastric cancer: The REAL 2 trial”.  J Clin Oncol, ASCO Annual Meeting Proceedings Part I. 2006;  24 No. 18 S LBA4017
    PubMedGoogle Scholar
  • 12 Einzig A, Neuberg D. et al . “Phase II trial of docetaxel (Taxotere) in patients with adenocarcinoma of the upper gastrointestinal tract previously untreated with cytotoxic chemotherapy: the Eastern Cooperative Oncology Group (ECOG) results of protocol E1293”.  Med Oncol. 1996;  13 87-93
    PubMedGoogle Scholar
  • 13 Engstrom P, Lavin P. et al . “Phase II evaluation of mitomycin and cisplatin in advanced esophageal carcinoma”.  Cancer Treat Rep. 1983;  67 713-715
    PubMedGoogle Scholar
  • 14 Enzinger P, Kulke M. et al . “A phase II trial of irinotecan in patients with previously untreated advanced esophageal and gastric adenocarcinoma”.  Dig Dis Sci. 2005;  50 2218-2223
    CrossrefPubMedGoogle Scholar
  • 15 Enzinger P, Mayer R. “Esophageal cancer”.  N Engl J Med. 2003;  349 2241-2252
    CrossrefPubMedGoogle Scholar
  • 16 Ezdinli E, Gelber R. et al . “Chemotherapy of advanced esophageal carcinoma: Eastern Cooperative Oncology Group experience”.  Cancer. 1980;  46 2149-2153
    CrossrefPubMedGoogle Scholar
  • 17 “Krebs in Deutschland. Häufigkeiten und Trends”. In Zusammenarbeit mit dem Robert-Koch-Institut, 5. überarbeitete, aktualisierte Ausgabe. Saarbrücken 2006
    Google Scholar
  • 18 Heath E, Urba S. et al . “Phase II trial of docetaxel chemotherapy in patients with incurable adenocarcinoma of the esophagus”.  Invest New Drugs. 2002;  20 95-99
    CrossrefPubMedGoogle Scholar
  • 19 Heinemann V, Quietzsch D. et al . “Randomized phase III trial of gemcitabine plus cisplatin compared with gemcitabine alone in advanced pancreatic cancer”.  J Clin Oncol. 2006;  24 3946-3952
    CrossrefPubMedGoogle Scholar
  • 20 Hess V, Salzberg M. et al . “Combining capecitabone and gemcitabine in patients with advanced pancreatic carcinoma: a phase I / II trial”.  J Clin Oncol. 2003;  21 (1) 66-68
    CrossrefPubMedGoogle Scholar
  • 21 Hettiarachchi R, Smorenburg S. et al . “Do heparins do more than just treat thrombosis? The influence of heparins on cancer spread”.  Thromb Haemost. 1999;  82 947-952
    PubMedGoogle Scholar
  • 22 Icli F, Akbulut H. et al . “Low molecular weight heparin (LMWH) increases the efficacy of cisplatinum plus gemcitabine combination in advanced pancreatic cancer”.  J Surg Oncol. 2006;  27 27
    PubMedGoogle Scholar
  • 23 Ilson D. “Phase II trial of weekly irinotecan / cisplatin in advanced esophageal cancer”.  Oncology (Williston Park). 2004;  18 (14 Suppl 14) 22-25
    PubMedGoogle Scholar
  • 24 Ilson D, Forastiere A. et al . “A phase II trial of paclitaxel and cisplatin in patients with advanced carcinoma of the esophagus”.  Cancer J. 2000;  6 316-323
    PubMedGoogle Scholar
  • 25 Ilson D, Wadleigh R. et al . “Paclitaxel given by a weekly 1-h infusion in advanced esophageal cancer”.  Ann Oncol. 2007;  18 898-902 ,  Epub 2007 Mar 9
    CrossrefPubMedGoogle Scholar
  • 26 Janmaat M, Gallegos-Ruiz M. et al . “Predictive factors for outcome in a phase II study of gefitinib in second-line treatment of advanced esophageal cancer patients”.  J Clin Oncol. 2006;  24 1612-1619
    CrossrefPubMedGoogle Scholar
  • 27 Kang Y, Kang W. et al . “Randomized phase III trial of capecitabine / cisplatin (XP) vs. continuous infusion of 5-FU / cisplatin (FP) as first-line therapy in patients (pts) with advanced gastric cancer (AGC): efficacy and safety results”.  J Clin Oncol, ASCO Annual Meeting Proceedings Part I. 2006;  24 No. 18 S LBA4018
    PubMedGoogle Scholar
  • 28 Kelsen D, Ginsberg R. et al . “Chemotherapy followed by surgery compared with surgery alone for localized esophageal cancer”.  N Engl J Med. 1998;  339 1979-1984
    CrossrefPubMedGoogle Scholar
  • 29 Kindler H, Niedzwiecki D. Cancer and Leukemia Group B . “A double-blind, placebo-controlled, randomized phase III trial of gemcitabine (G) plus bevacizumab (B) versus gemcitabine plus placebo (P) in patients (pts) with advanced pancreatic cancer (PC): A preliminary analysis of Cancer and Leukemia Group B (CALGB)”.  J Clin Oncol ASCO Annual Meeting Proceedings Part I. 2007;  25 No. 18 S 4508
    PubMedGoogle Scholar
  • 30 Lordick F, Lorenzen S. et al . “Cetuximab plus weekly oxaliplatin / 5FU / FA (FUFOX) in 1st line metastatic gastric cancer. Final results from a multicenter phase II study of the AIO upper GI study group”.  J Clin Oncol, ASCO Annual Meeting Proceedings Part I. 2007;  25 No. 18 S 4526
    PubMedGoogle Scholar
  • 31 Louvet C, Hincke A. et al . “Increased survival using platinum analog combined with gemcitabine as compared to gemciatbien single agent in advanced pancreatic cancer: Pooled analysis of tow randomised trials, the GERCOR / GISCAD Intergroup Study and a German multicenter Study”.  J Clin Oncol. 2006;  24 No. 18 S 4003
    CrossrefPubMedGoogle Scholar
  • 32 Louvet C, Labianca R. et al . “Gemcitabine in combination with oxaliplatin compared with gemcitabine alone in locally advanced or metastatic pancreatic cancer: results of a GERCOR and GISCAD phase III trial”.  J Clin Oncol. 2005;  23 3509-3516
    CrossrefPubMedGoogle Scholar
  • 33 Lutz M, Wilke H. et al . “Weekly infusional high-dose fluorouracil (HD-FU), HD-FU plus folinic acid (HD-FU / FA), or HD-FU / FA plus biweekly cisplatin in advanced gastric cancer: randomized phase II trial 40953 of the European Organisation for Research and Treatment of Cancer Gastrointestinal Group and the Arbeitsgemeinschaft Internistische Onkologie”.  J Clin Oncol. 2007;  25 2580-2585
    CrossrefPubMedGoogle Scholar
  • 34 Millela M, Carlini A. et al . “Gemcitabine-based polychemotherapy for advanced pancreatic cancer: Is it ready for prime time? A pooled analysis of 3 682 patients enrolled in 12 phase II trials”.  J Clin Oncol, ASCO Annual Meeting Proceedings Part I. 2006;  24 No. 18 S 4118
    PubMedGoogle Scholar
  • 35 Moore M, Goldstein D. et al . “Erlotinib plus gemcitabine compared with gemcitabine alone in patients with advanced pancreatic cancer: a phase III trial of the National Cancer Institute of Canada Clinical Trials Group”.  J Clin Oncol. 2007;  25 1960-1966 ,  Epub 2007 Apr 23
    CrossrefPubMedGoogle Scholar
  • 36 Muro K, Hamaguchi T. et al . “A phase II study of single-agent docetaxel in patients with metastatic esophageal cancer”.  Ann Oncol. 2004;  15 955-959
    CrossrefPubMedGoogle Scholar
  • 37 Narahara H, Koizumi W. et al . “Randomized phase III study of S-1 alone versus S-1 + cisplatin in the treatment for advanced gastric cancer (The SPIRITS trial) SPIRITS: S-1 plus cisplatin vs S-1 in RCT in the treatment for stomach cancer”.  J Clin Oncol, ASCO Annual Meeting Proceedings Part I. 2007;  25 No. 18 S 4514
    PubMedGoogle Scholar
  • 38 Pelzer U, Hilbig A. et al . “ A prospective, randomized trial of simultaneous pancreatic cancer treatment with enoxaparin and chemotherapy (PROSPECT - CONKO 004)”.  J Clin Oncol, ASCO Annual Meeting Proceedings Part I. 2006;  24 No. 18 S 4110
    PubMedGoogle Scholar
  • 39 Pinto C, Di Fabio F. et al . “Phase II study of cetuximab in combination with FOLFIRI in patients with untreated advanced gastric or gastroesophageal junction adenocarcinoma (FOLCETUX study)”.  Ann Oncol. 2007;  18 510-517 ,  Epub 2006 Dec 12
    PubMedGoogle Scholar
  • 40 Rickles F, Edwards R. “Activation of blood coagulation in cancer: Trousseau's syndrome revisited”.  Blood. 1983;  62 14-31
    PubMedGoogle Scholar
  • 41 Ross P, Nicolson M. et al . “Prospective randomized trial comparing mitomycin, cisplatin, and protracted venous-infusion fluorouracil (PVI 5-FU) With epirubicin, cisplatin, and PVI 5-FU in advanced esophagogastric cancer”.  J Clin Oncol. 2002;  20 1996-2004
    CrossrefPubMedGoogle Scholar
  • 42 Sener S, Fremgen A. et al . “Pancreatic cancer: a report of treatment and survival trends for 100 313 patients diagnosed from 1985-1995, using the National Cancer Database”.  J Am Coll Surg. 1999;  189 1-7
    CrossrefPubMedGoogle Scholar
  • 43 Shah M, Ramanathan R. et al . “Multicenter phase II study of irinotecan, cisplatin, and bevacizumab in patients with metastatic gastric or gastroesophageal junction adenocarcinoma”.  J Clin Oncol. 2006;  24 5201-5206
    CrossrefPubMedGoogle Scholar
  • 44 Shen V, Pollak E. “Fatal pulmonary embolism in cancer patients: is heparin prophylaxis justified”?.  South Med J. 1980;  73 841-843
    PubMedGoogle Scholar
  • 45 Tebbutt N, Sourjina T. et al . “ATTAX: Randomised phase II study evaluating weekly docetaxel-based chemotherapy combinations in advanced esophago-gastric cancer, final results of an AGITG trial”.  J Clin Oncol, ASCO Annual Meeting Proceedings Part I. 2007;  25 No. 18 S 4528
    PubMedGoogle Scholar
  • 46 Van Cutsem E, Moiseyenko V. et al . “Phase III study of docetaxel and cisplatin plus fluorouracil compared with cisplatin and fluorouracil as first-line therapy for advanced gastric cancer: a report of the V325 Study Group”.  J Clin Oncol. 2006;  24 4991-4997
    CrossrefPubMedGoogle Scholar
  • 47 Wagner A, Grothe W. et al . “Chemotherapy in advanced gastric cancer: a systematic review and meta-analysis based on aggregate data”.  J Clin Oncol. 2006;  24 2903-2909
    CrossrefPubMedGoogle Scholar
  • 48 Webb A, Cunningham D. et al . “Randomized trial comparing epirubicin, cisplatin, and fluorouracil versus fluorouracil, doxorubicin, and methotrexate in advanced esophagogastric cancer”.  J Clin Oncol. 1997;  15 261-267
    PubMedGoogle Scholar
  • 49 Whittington R, Close H. “Clinical Experience with Mitomycin”.  Cancer Chem Rep. 1970;  54 195
    PubMedGoogle Scholar

PD Dr. H. Oettle
Dr. M. Sinn

Charité - Universitätsmedizin Berlin · CharitéCentrum für Tumormedizin · Med. Klinik m. S. Hämatologie / Onkologie

Augustenburger Platz 1

13353 Berlin

Phone: +49 / 30 / 4 50 / 55 32 22

Fax: +49 / 30 / 4 50 / 55 39 59

Email: helmut.oettle@charite.de

Email: marianne.sinn@charite.de

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