Zusammenfassung
Nach Resektion eines Pankreaskarzinoms ist die adjuvante Chemotherapie, die über einen Zeitraum von 6 Monaten durchgeführt wird, etablierter klinischer Standard. Im Rahmen mehrerer randomisierter Studien konnten mediane Überlebenszeiten von 20–24 Monaten erreicht werden. Die unter der adjuvanten Behandlung erreichten 5-Jahres-Überlebensraten konnten im Vergleich zur alleinigen Beobachtung verdoppelt werden und lagen in mehreren Analysen bei 21–24 %. Sowohl Gemcitabin als auch 5-Fluorouracil können bei vergleichbarer Effektivität, allerdings bei unterschiedlichen Toxizitätsspektren, in der adjuvanten Behandlung eingesetzt werden.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
Literatur
Butturini G, Stocken DD, Wente MN et al (2008) Influence of resection margins and treatment on survival in patients with pancreatic cancer: meta-analysis of randomized controlled trials. Arch Surg 143: 75–83; discussion 83
Conroy T, Desseigne F, Ychou M et al (2011) FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med 364: 1817–1825
Hidalgo M (2010) Pancreatic cancer. N Engl J Med 362: 1605–1617
von Hoff DD, Ervin TJ, Arena FP et al (2012) Randomized phase III study of weekly nab-paclitaxel plus gemcitabine versus gemcitabine alone in patients with metastatic adenocarcinoma of the pancreas (MPACT). J Clin Oncol 30 (Suppl 34): abstract LBA148
Kalser MH, Ellenberg SS (1985) Pancreatic cancer. Adjuvant combined radiation and chemotherapy following curative resection. Arch Surg 120: 899–903
Klinkenbijl JH, Jeekel J, Sahmoud T et al (1999) Adjuvant radiotherapy and 5-fluorouracil after curative resection of cancer of the pancreas and periampullary region: phase III trial of the EORTC gastrointestinal tract cancer cooperative group. Ann Surg 230: 776–782; discussion 782–774
Kosuge T, Kiuchi T, Mukai K, Kakizoe T (2006) A multicenter randomized controlled trial to evaluate the effect of adjuvant cisplatin and 5-fluorouracil therapy after curative resection in cases of pancreatic cancer. Jpn J Clin Oncol 36: 159–165
van Laethem JL, Hammel P, Mornex F et al (2010) Adjuvant gemcitabine alone versus gemcitabine-based chemoradiotherapy after curative resection for pancreatic cancer: a randomized EORTC-40013-22012/FFCD-9203/GERCOR phase II study. J Clin Oncol 28: 4450–4456
Marten A, Schmidt J, Debus J et al (2010) CapRI: Final results of the open-label, multicenter, randomized phase III trial of adjuvant chemoradiation plus interferon-α2b (CRI) versus 5-FU alone for patients with resected pancreatic adenocarcinoma (PAC). J Clin Oncol 28: LBA4012
Neoptolemos JP, Moore M, Cox TF et al (2011) Ampullary cancer ESPAC-3 (v2) trial: a multicenter, international, open-label, randomized controlled phase III trial of adjuvant chemotherapy versus observation in patients with adenocarcinoma of the ampulla of vater. J Clin Oncol 29: LBA4006
Neoptolemos JP, Stocken DD, Dunn JA et al (2001) Influence of resection margins on survival for patients with pancreatic cancer treated by adjuvant chemoradiation and/or chemotherapy in the ESPAC-1 randomized controlled trial. Ann Surg 234: 758–768
Neoptolemos JP, Stocken DD, Friess H et al (2004) A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer. N Engl J Med 350: 1200–1210
Neuhaus P, Riess H, Post S et al (2008) CONKO-001: Final results of the randomized, prospective, multicenter phase III trial of adjuvant chemotherapy with gemcitabine versus observation in patients with resected pancreatic cancer (PC). J Clin Oncol 26: LBA4504
Oettle H, Post S, Neuhaus P et al (2007) Adjuvant chemotherapy with gemcitabine vs observation in patients undergoing curative-intent resection of pancreatic cancer. JAMA 297: 267–277
Regine WF, Winter KA, Abrams R et al (2011) Fluorouracil-based chemoradiation with either gemcitabine or fluorouracil chemotherapy after resection of pancreatic adenocarcinoma: 5-year analysis of the U.S. Intergroup/RTOG 9704 phase III trial. Ann Surg Oncol 18: 1319–1326
Regine WF, Winter KA, Abrams RA et al (2008) Fluorouracil vs gemcitabine chemotherapy before and after fluorouracil-based chemoradiation following resection of pancreatic adenocarcinoma: a randomized controlled trial. JAMA 299: 1019–1026
Reni M, Balzano G, Aprile G et al (2012) Adjuvant PEFG (Cisplatin, Epirubicin, 5-Fluorouracil, Gemcitabine) or Gemcitabine followed by chemoradiation in pancreatic cancer: a randomized phase II trial. Ann Surg Oncol 19:225b–2263
Ueno H, Kosuge T, Matsuyama Y et al (2009) A randomised phase III trial comparing gemcitabine with surgery-only in patients with resected pancreatic cancer: Japanese Study Group of Adjuvant Therapy for Pancreatic Cancer. Br J Cancer 101: 908–915
Wolff RA, Varadhachary GR, Evans DB (2008) Adjuvant therapy for adenocarcinoma of the pancreas: analysis of reported trials and recommendations for future progress. Ann Surg Oncol 15: 2773–2786
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Heinemann, V. (2013). Evidenz der adjuvanten Chemotherapie beim Pankreaskarzinom. In: Beger, H., et al. Erkrankungen des Pankreas. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37964-2_73
Download citation
DOI: https://doi.org/10.1007/978-3-642-37964-2_73
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-37963-5
Online ISBN: 978-3-642-37964-2
eBook Packages: Medicine (German Language)