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.
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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
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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
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DOI: https://doi.org/10.1007/978-3-642-37964-2_73
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