Medikamentöse Therapie in Der Gastroenterologie
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Es sterben mehr Menschen an bösartigen Tumoren des Verdau- ungstrakts als an Malignomen aller anderen Organe zusammen. Die Prognose bei dem individuellen Tumor ist um so besser, je wei- ter man sich von der Speiseröhre zum Dickdarm bewegt. Das grö te Hindernis einer erfolgreichen Behandlung der Tumoren des oberen Gastrointestinaltrakts liegt darin, da sie erst in einem späten Stadium der Erkrankung klinisch manifest werden. Zu die- sem Zeitpunkt ist der Krebs oft bereits über die Organgrenzen hin- ausgewachsen oder hat auf dem Lymph- oder Blutweg Fernmeta- stasen gesetzt. Obgle}ch die chirurgische Resektion bis heute an erster Stelle der Behandlungsmethoden steht, ist es sei Mitte dieses Jahrhunderts nicht gelungen, die chirurgischen Behandlungsergebnisse nennens- wert zu verbessern. Die Endresultate sind enttäuschend mit Fünf- jahresüberlebensraten von 5% beim Ösophagus-, Pankreas-, Leber- und Gallenwegkarzinom und 12% beim Magenkrebs [1]. Selbst auf dem Gebiet der besten chirurgischen Erfolge, dem des Kolonkarzi- noms, sterben mehr als 50% aller an diesem Tumor Erkrankten. So ist es zu verstehen, da in den letzten Jahren zusätzliche Thera- piewege mehr und mehr Teil eines Gesamtbehandlungsplans wur- den, so z. B. die präoperative Bestrahlung des Rektumkarzinoms oder die postoperative Chemotherapie des Magenkrebses. Es ist damit zu rechnen, da die nächsten Jahre weitere Daten in dieser Richtung bringen werden.
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