Medicamenteuze behandeling van patiënten met colorectumcarcinoom

- Colorectal cancer is a frequently occurring malignancy in the western world. In the Netherlands, there are more than 9000 new patients annually. Approximately half of the patients die of their disease within 5 years.

- In 2004, several therapeutic studies were presented, the results of which may have a positive impact on the prognosis of a large proportion of patients. This concerns the adjuvant treatment of stage II and III colon carcinoma and the palliative systemic treatment of distant metastases of colorectal carcinoma.

- In stage II colon carcinoma, the absolute benefit of adjuvant treatment is 3-4. This must be balanced against the burden of such treatment.

- Adjuvant treatment with fluorouracil-folinic acid-oxaliplatin is indicated in stage III colon carcinoma and should be considered for patients with stage II colon cancer in whom the prognosis is unfavourable.

- For patients for whom treatment with fluorouracil-folinic acid-oxaliplatin does not seem suitable, adjuvant treatment with capecitabine is indicated.

- Treatment with bevacizumab, a monoclonal antibody against vascular endothelial growth factor, in combination with chemotherapy is considered to be standard practice in first-line treatment.

- Together with the expected rise in the incidence of colorectal cancer, these developments will have a significant impact on healthcare, both in terms of organization and budget.

Ned Tijdschr Geneeskd 2005;149:1441-7