Therapeutic options in the management of colon cancer: 2005 update.
Therapeutic options in the management of colon cancer: 2005 update.
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DOI：
10.1188/05.cjon.31-44
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发表时间：
2005-02-01
影响因子：
1.1
通讯作者：
Wilkes, Gail M
中科院分区：
文献类型：
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作者：
Wilkes, Gail M
最近，结肠癌治疗的重大进展已经出现。这些进展包括手术技术和分期的改进以及新的分子靶向药物的引入。手术治疗的改进包括增强分期技术，从而更准确地确定复发风险。较新的药物，如奥沙利铂，西妥昔单抗和贝伐单抗，现在被批准用于治疗结肠癌。奥沙利铂在辅助治疗和转移性疾病中使用的相关数据继续成熟;预计生存获益将在未来两年更加明显。贝伐单抗是一种中和血管内皮生长因子的单克隆抗体，当与伊立替康、5-氟尿嘧啶和亚叶酸（IFL）联合使用时，在实现中位生存期和无进展生存期方面上级IFL单药。西妥昔单抗是一种针对表皮生长因子受体的单克隆抗体，与伊立替康联合给药时，在含伊立替康方案难治性患者中，与西妥昔单抗单药相比，客观缓解率增加，至疾病进展时间延长。除了手术和药理学的发展，遗传学和分子标记在致癌作用中发挥重要作用的认识，提高了研究，将这一知识融入实践。护士在结肠癌患者的护理中起着关键作用，必须熟悉治疗的新进展。
Recently, major developments in the treatment of colon cancer have emerged. These developments include improvements in surgical technique and staging and the introduction of new molecularly targeted pharmacologic agents. Improvements in surgical management involve enhanced staging techniques, allowing more accurate determination of risk of recurrence. Newer agents, such as oxaliplatin, cetuximab, and bevacizumab, now are approved for the treatment of colon cancer. The data associated with use of oxaliplatin in adjuvant and metastatic settings continue to mature; survival benefits are expected to become more fully apparent in the next two years. Bevacizumab, a monoclonal antibody that neutralizes vascular endothelial growth factor, when combined with irinotecan, 5-fluorouracil, and leucovorin (IFL), was superior to IFL alone in achieving median and progression-free survival. Cetuximab, a monoclonal antibody directed against the epidermal growth factor receptor, when given in combination with irinotecan, achieved an increased objective response and increased time to progression, compared with cetuximab alone, in patients refractory to irinotecan-containing regimens. In addition to surgical and pharmacologic developments, the recognition that genetics and molecular markers play an important role in carcinogenesis has heightened research to integrate this knowledge into practice. Nurses play a pivotal role in the care of patients with colon cancer and must be conversant in the new advances in treatment.