Contemporary methods of treatment of colorectal cancer

Abstract

Today, colorectal cancer (CRC) is the third most frequently diagnosed worldwide malignant cancer in males, and the second in females, with more than 1,200,000 new cases and more than 600,000 deaths, annually. Screening tests in oncology allow the detection of cancerous disease at an early, asymptomatic stage. The procedures most frequently performed in the case of colorectal cancer include: low anterior resection by the Dixon method (manual suture or staplers); abdominoperineal resection of the rectum by the Miles method; surgical procedure by the Hartmann method; local resection. Various techniques of preoperative radiotherapy are applied, aimed at tumour mass reduction (scheme I) and/or obtaining local sterilisation (schemes I and II), which results in the reduction of local metastases (by approximately 50%), as well as an improvement with respect to long-term survival (by approximately 10%). At present, the following drugs for treatment of various forms of colorectal cancer have been registered by the Food and Drug Administration (FDA): fluorouracil capecitabine irinotecan, oxaliplatin, cetuximab, and bevacizumab. The combination of complete cytoreductive surgery (CCS), the goal of which is the removal of all visible (macroscopically) cancer foci, with a simultaneous intraperitoneal chemotherapy in hyperthermia -HIPEC, destroying microscopic remains of the disease, allows the curing of some patients with peritoneal cancer. The effect of the action of monoclonal antibodies -cetuximab and panitumumab -is the inhibition of proliferation of cancer cells, intensification of their apoptosis, as well as reduction of synthesis and secretion of pro-angiogenic factors, such as interleukin 8 (IL-8) and vascular endothelial growth factor. In addition, antibodies targeted against EGFR impair the repair of DNA damage caused by chemotherapy and radiotherapy in the cells of the malignant tumour. StreszczenieWspółcześnie rak jelita grubego jest trzecim najczęściej diagnozowanym nowotworem złośliwym na świecie u mężczyzn, a drugim u kobiet, z ponad 1 200 000 nowymi przypadkami i ponad 600 000 zgonami rocznie. Badania przesiewowe w onkologii pozwalają wykrywać chorobę nowotworową we wczesnej, bezobjawowej fazie. Do najczęściej wykonywanych zabiegów w przypadku raka odbytnicy należą: niska przednia resekcja sposobem Dixona (zespolenie ręczne lub staplery), amputacja brzuszno-kroczowa odbytnicy sposobem Milesa, operacja sposobem Hartmanna i wycięcie miejscowe. Stosuje się różne techniki radioterapii przedoperacyjnej, która ma na celu zmniejszenie masy guza (schemat I) i/lub uzyskanie sterylizacji miejscowej (schemat I, II), co wpływa na zmniejszenie wznów miejscowych (o ok. 50%) oraz poprawę przeżyć odległych (o ok. 10%). Obecnie do leczenia różnych postaci raka jelita grubego, w tym odbytnicy, zostały zarejestrowane przez Agencję ds. Żywności i Leków (FDA) następujące leki: fluorouracyl, kapecytabina, irinotekan, oksaliplatyna, cetuksymab, bewacizumab. Połączenie operacji całkowitej cytoredukcji, mającej na celu usunięci...

The Influence of Red Meat on Colorectal Cancer Occurrence Is Dependent on the Genetic Polymorphisms of S-Glutathione Transferase Genes

“…Despite the fact that red meat has been recognized as a cancer-promoting factor, the results of studies do not always explicitly confirm the relationship between the consumption of red and processed meat with the risk of gastrointestinal cancers [6,9]. A pooled analysis of over 8000 CRC cases and more than 9000 controls did not indicate a significant relationship between red meat consumption and colorectal cancer in prospective studies, but only for case–control studies [10].…”

GSTM1, GSTT1, and GSTP1 polymorphisms and colorectal cancer risk in Polish nonsmokers

“…CRC causes include heterogeneous, controllable, and external factors related to lifestyle, such as diet and socioeconomic standing [ 2 ]. Such factors include high consumption of red meat, insufficient intake of fiber, vitamins, and minerals (calcium, selenium, zinc, copper, manganese, folic acid), excessive fat consumption, obesity, and lack of exercise.…”

Conventional colon adenomas harbor various disturbances in microsatellite stability and contain micro-serrated foci with microsatellite instability

“…Additionally there are contradictory researches about the overall survival (OS) rate in light of 5-fluorouracil based chemotherapy and the predictive value of MSI status in planning adjuvant therapy [ 10 – 12 ]. At present, neoadjuvant chemotherapy schemes such as IFL, FOLFOX or fluorouracil-bevacizumab are used without clear guidelines based on molecular signaling paths[ 13 ]. Currently, we dispose the blocking EGFR dependent MAPK/mTOR path by cetuximab and VEGF dependent signaling by bevacizumab.…”