Skip to main content

Colorectal Cancer: Optimization of the Combination of 5-Fluorouracil and Irinotecan

  • Chapter
Colorectal Cancer

Part of the book series: Methods of Cancer Diagnosis, Therapy, and Prognosis ((HAYAT,volume 4))

  • 2097 Accesses

Colorectal cancer (CRC) is the third lead ing cause of cancer in both men and women worldwide (Goldberg, 2005). Upon diag nosis, 19% of CRC cases are metastatic, and while the overall 5-year survival rate for patients with early CRC is ∼ 60%, the rate drops to 10% or less in patients with advanced disease (Goldberg, 2005).

5-Fluorouracil (FU) has been for many years the backbone of therapy for CRC since it demonstrated to improve patients overall survival either in the adjuvant set ting or in the metastatic disease (Goldberg, 2005). Based on the evidence that FU has a schedule-dependent activity, various strategies have been evaluated to improve their cytotoxic effects, such as changing the dose, the schedule and route of admin istration or combining with the biomodula-tor leucovorin, overall obtaining response rates of ~ 15–25% (Venook, 2005).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 259.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 329.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 329.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • André, T., Louvet, C., Maindrault-Goebel, F., Couteau, C., Mabro, M., Lotz, J.P., Gilles-Amar, V., Krulik, M., Carola, E., Izrael, V., and de Gramont, A. 1999. CPT-11 (irinotecan) addition to bimonthly, high-dose leucovorin and bolus and continuous-infusion 5-fluorouracil (FOLFIRI) for pretreated metastatic colorectal cancer. GERCOR. Eur. J. Cancer 35: 1343–1347.

    Article  PubMed  Google Scholar 

  • André, T., Boni, C., Mounedji-Boudiaf, L., Navarro, M., Tabernero, J., Hickish, T., Topham, C., Zaninelli, M., Clingan, P., Bridgewater, J., Tabah-Fisch, I., and de Gramont, A., Multicenter International Study of Oxaliplatin/5-Fluorouracil/ Leucovorin in the Adjuvant Treatment of Colon Cancer (MOSAIC) Investigators. 2004. Oxaliplatin, fluorouracil, and leucovorin as adju vant treatment for colon cancer. N. Engl. J. Med. 350: 2343–2351.

    Article  PubMed  Google Scholar 

  • Aschele, C., Baldo, C., Sobrero, A.F., Debernardis, D., Bornmann, W.G., and Bertino, J.R. 1998. Schedule-dependent synergism between ralti-trexed and irinotecan in human colon cancer cells in vitro. Clin. Cancer Res. 4: 1323–1330.

    PubMed  CAS  Google Scholar 

  • Barone, C., Landriscina, M., Quirino, M., Basso, M., Pozzo, C., Schinzari, G., Di Leonardo, G., D'Argento, E., Trigila, N., and Cassano, A. 2007. Schedule-dependent activity of 5-fluorou-racil and irinotecan combination in the treatment of human colorectal cancer: in vitro evidence and a phase I dose-escalating clinical trial. Br. J. Cancer 96: 21–28.

    Article  PubMed  CAS  Google Scholar 

  • Ciaparrone, M., Quirino, M., Schinzari, G., Zannoni, G., Corsi, D.C., Vecchio, F.M., Cassano, A., La Torre, G., and Barone, C. 2006. Predictive role of thymidylate synthase, dihydropyrimidine dehydrogenase and thymidine phosphorylase expression in colorectal cancer patients receiving adjuvant 5-fluorouracil. Oncology 70: 366–377.

    Article  PubMed  CAS  Google Scholar 

  • Cunningham, D., Humblet, Y., Siena, S., Khayat, D., Bleiberg, H., Santoro, A., Bets, D., Mueser, M., Harstrick, A., Verslype, C., Chau, I., and Van Cutsem, E. 2004. Cetuximab monotherapy and cetuximab plus irinotecan-refractory metastatic colorectal cancer. N. Engl. J. Med. 351: 337–345.

    Article  PubMed  CAS  Google Scholar 

  • Cure, H., Chevalier, V., Adenis, A., Tubiana-Mathieu, N., Niezgodzki, G., Kwiatkowski, F., Pezet, D., Perpoint, B., Coudert, B., Focan, C., Lévi, F., Chipponi, J., and Chollet, P. 2002. Phase II trial of chronomodulated infusion of high-dose fluorouracil and l-folinic acid in pre viously untreated patients with metastatic color-ectal cancer. J. Clin. Oncol. 20: 1175–1181.

    Article  PubMed  CAS  Google Scholar 

  • Del Rio, M., Molina, F., Bascoul-Mollevi, C., Copois, V., Bibeau, F., Chalbos, P., Bareil, C., Kramar, A., Salvetat, N., Fraslon, C., Conseiller, E., Granci, V., Leblanc, B., Pau, B., Martineau, P., and Ychou, M. 2007. Gene expression signature in advanced colorectal cancer patients select drugs and response for the use of leucovorin, fluorour-acil, and irinotecan. J. Clin. Oncol. 25: 773–780.

    Article  PubMed  CAS  Google Scholar 

  • Douillard, J.Y., Cunningham, D., Roth, A.D., Navarro, M., James, R.D., Karasek, P., Jandik, P., Iveson, T., Carmichael, J., Alakl, M., Gruia, G., Awad, L., and Rougier, P. 2000. Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicentre rand omized trial. Lancet 355: 1041–1047.

    Article  PubMed  CAS  Google Scholar 

  • Falcone, A., Ricci, S., Brunetti, I., Pfanner, E., Algerini, G., Barbara, C., Crinò, L., Benedetti, G., Evangelista, W., Fanchini, L., Cortesi, E., Picone, V., Vitello, S., Chiara, G., Granetto, C., Porcile, G., Fioretto, L., Orlandini, C., Andreucci, M., and Masi, G., Gruppo Oncologico Nord Ovest. 2007. Phase III trial of infusional fluor-ouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) compared with infusional fluor-ouracil, leucovorin, and irinotecan (FOLFIRI) as first-line treatment for metastatic colorectal cancer; the Gruppo Oncologico Nord Ovest. J. Clin. Oncol. 25: 1670–1676.

    Article  PubMed  CAS  Google Scholar 

  • Ferrara, N. 2001. Role of vascular endothelial growth factor in regulation of physiological angiogenesis. Am. J. Physiol. Cell. Physiol. 280: C1358–C1366.

    PubMed  CAS  Google Scholar 

  • Ficorella, C., Ricevuto, E., Morelli, M.F., Morese, R., Cannita, K., Cianci, G., Porzio, G., Di Rocco, Z.C., De Galitiis, F., De Tursi, M., Tinari, N., Iacobelli, S., and Marchetti, P. 2006. Increased tolerability of bimonthly 12-hours timed flat infusion 5-fluorouracil/irinotecan regimen in advanced colorectal cancer: a dose-finding study. Oncol. Rep. 15: 1345–1350.

    PubMed  CAS  Google Scholar 

  • Fuchs, C., Mitchell, E.P., and Hoff, P.M. 2006. Irinotecan in the treatment of colorectal cancer. Cancer Treat. Rev. 32: 491–503.

    Article  PubMed  CAS  Google Scholar 

  • Garufi, C., Bria, E., Vanni, B., Zappala, A.M., Sperduti, I., and Terzoli, E. 2003. A phase II study of irinotecan plus chronomodulated oxali-platin, 5-fluorouracil and folinic acid in advanced colorectal cancer patients. Br. J. Cancer 89: 1870–1875.

    Article  PubMed  CAS  Google Scholar 

  • Garufi, C., Vanni, B., Aschelter, A.M., Zappalà, A.R., Bria, E., Nisticò, C., Sperduti, I., Cognetti, F., and Terzoli, E. 2006. Randomized phase II study of standard versus chronomodulated CPT-11 plus chronomodulated 5-fluorouracil and folinic acid in advanced colorectal cancer patients. Eur. J. Cancer 42: 608–616.

    Article  PubMed  CAS  Google Scholar 

  • Giantonio, B.J., Catalano, P.J., Meropol, N.J., O'Dwyer, P.J., Mitchell, E.P., Alberts, S.R., Schwartz, M.A., and Benson, A.B.; Eastern Cooperative Oncology Group Study E3200. 2007. Bevacizumab in combination with oxali-platin, fluorouracil, and leucovorin (FOLFOX4) for previously treated metastatic colorectal cancer: results from the Eastern Cooperative Oncology Group Study E3200. J. Clin. Oncol. 25: 1539–1544.

    Article  PubMed  CAS  Google Scholar 

  • Goetz, M.P., Erlichman, C., Windebank, A.J., Reid, J.M., Sloan, J.A., Atherton, P., Adjei, A.A., Rubin, J., Pitot, H., Galanis, E., Ames, M.M., and Goldberg, R.M. 2003. Phase I and phar-macokinetic study of two different schedules of oxaliplatin, irinotecan, fluorouracil, and leucov-orin in patients with solid tumors. J. Clin. Oncol. 21: 3761–3769.

    Article  PubMed  CAS  Google Scholar 

  • Goldberg, R.M. 2005. Advances in the treatment of metastatic colorectal cancer. Oncologist 10 (Suppl 3): 40–48.

    Article  PubMed  CAS  Google Scholar 

  • Grothey, A., Sargent, D., Goldberg, R.M., and Schmoll, H.J. 2004. Survival of patients with advanced colorectal cancer improves with the availability of fluorouracil-leucovorin, irinote-can, and oxaliplatin in the course of treatment. J. Clin. Oncol. 22: 1209–1214.

    Article  PubMed  CAS  Google Scholar 

  • Guichard, S., Hennebelle, I., Bugat, R., and Canal, P. 1998. Cellular interaction of 5-fluorouracil and the camptothecin analogue CPT-11 (irinote-can) in human colorectal carcinoma cell line. Biochem. Pharmacol. 55: 667–676.

    Article  PubMed  CAS  Google Scholar 

  • Hanahan, D., and Folkman, J. 1996. Patterns and emerging mechanisms of the angiogenic switch during tumorigenesis. Cell 86: 353–364.

    Article  PubMed  CAS  Google Scholar 

  • Hurwitz, H.I., Fehrenbacher, L., Novotny, W., Cartwright, T., Hainsworth, J., Heim, W., Berlin, J., Baron, A., Griffing, S., Holmgren, E., Ferrara, N., Fyfe, G., Rogers, B., Ross, R., and Kabbinavar, F. 2004. Bevacizumab plus iri-notecan, fluorouracil, and leucovorin for meta-static colorectal cancer. N. Engl. J. Med. 350: 2335–2342.

    Article  PubMed  CAS  Google Scholar 

  • Iacopetta, B., Grieu, F., Joseph, D., and Elsaleh, H. 2001. A polymorphism in the enhancer region of the thymidylate synthase promoter influences the survival of colorectal cancer patients treated with 5-fluorouracil. Br. J. Cancer 85: 827–830.

    Article  PubMed  CAS  Google Scholar 

  • Köhne, C.H., van Cutsem, E., Wils, J., Bokemeyer, C., El-Serafi, M., Lutz, M.P., Lorenz, M., Reichardt, P., Ruckle-Lanz, H., Frickhofen, N., Fuchs, R., Mergenthaler, H.G., Langenbuch, T., Vanhoefer, U., Rougier, P., Voigtmann, R., Muller, L., Genicot, B., Anak, O., and Nordlinger, B., European Organisation for Research and Treatment of Cancer Gastrointestinal Group. 2005. Phase III study of weekly high-dose infu-sional fluorouracil plus folinic acid with or without irinotecan in patients with metastatic colorectal cancer: European Organisation for Research and Treatment of Cancer Gastrointestinal Group Study 40986. J. Clin. Oncol. 23: 4856–4865.

    Article  PubMed  Google Scholar 

  • Kornmann, M., Schwabe, W., Sander, S., Kron, M., Sträter, J., Polat, S., Kettner, E., Weiser, H.F., Baumann, W., Schramm, H., Häusler, P., Ott, K., Behnke, D., Staib, L., Beger, H.G., and Link, K.H. 2003. Thymidylate synthase and dihydro-pyrimidine dehydrogenase mRNA expression levels: Predictors for survival in colorectal can cer patients receiving adjuvant 5-fluorouracil. Clin. Cancer Res. 9: 4116–4124.

    PubMed  CAS  Google Scholar 

  • Lévi, F., Perpoint, B., Garufi, C., Focan, C., Chollet, P., Depres-Brummer, P., Zidani, R., Brienza, S., Itzhaki, M., and Iacobelli, S. 1993. Oxaliplatin activity against metastatic colorectal cancer. A phase II study of 5-day continuous infusion at circadian rhythm modulated rate. Eur. J. Cancer 29A: 1280–1284.

    Article  PubMed  Google Scholar 

  • Mans, D.R.A., Grivicich, I., Peters, G.J., and Schwartsmann, G. 1999. Sequence-dependent growth inhibition and DNA damage formation by the irinotecan-5-fluorouracil combination in human colon carcinoma cell lines. Eur. J. Cancer 13: 1851–1861.

    Article  Google Scholar 

  • Mariadason, J.M., Arango, D., Shi, Q., Wilson, A.J., Corner, G.A., Nicholas, C., Aranes, M.J., Lesser, M., Schwartz, E.L., and Augenlicht, L.H. 2003. Gene expression profiling-based prediction of response of colon carcinoma cells to 5-fluorouracil and camptothecin. Cancer Res. 63: 8791–8812.

    PubMed  CAS  Google Scholar 

  • Martinez-Balibrea, E., Manzano, J.L., Martinez-Cardus, A., Moran, T., Cirauqui, B., Catot, S., Taron, M., and Abad, A. 2007. Combined analysis of genetic polymorphisms in thymi-dylate synthase, uridine diphosphate glucorono-syltransferase and X-ray cross complementing factor 1 genes as a prognostic factor in advanced colorectal cancer patients treated with 5-fluorou-racil plus oxaliplatin or Irinotecan. Oncol. Rep. 17: 637–645.

    PubMed  CAS  Google Scholar 

  • Mendelsohn, J., and Baselga, J. 2000. The EGF receptor family as targets for cancer therapy. Oncogene 19: 6550–6565.

    Article  PubMed  CAS  Google Scholar 

  • Paradiso, A., Xu, J., Mangia, A., Chiriatti, A., Simone, G., Zito, A., Montemurro, S., Giuliani, F., Maiello, E., and Colucci, G. 2004. Topoisomerase-I, thymidylate synthase primary tumor expression and clinical efficacy of 5-FU/ CPT-11 chemotherapy in advanced colorectal cancer patients. Int. J. Cancer 111: 252–258.

    Article  PubMed  CAS  Google Scholar 

  • Peng, X.H., Karna, P., Cao, Z., Jiang, B.H., Zhou, M., and Yang, L. 2006. Cross-talk between epidermal growth factor receptor and hypoxia-inducible factor-1alpha signal pathways increases resistance to apoptosis by up-regulating sur viving gene expression. J. Biol. Chem. 281: 25903–25914.

    Article  PubMed  CAS  Google Scholar 

  • Poplin, E.A., Benedetti, J.K., Estes, N.C., Haller, D.G., Mayer, R.J., Goldberg, R.M., Weiss, G.R., Rivkin, S.E., and Macdonald, J.S. 2005. Phase III Southwest Oncology Group 9415/Intergroup 0153 randomized trial of fluorouracil, leucovorin, and levamisole versus fluorouracil continuous infusion and levamisole for adjuvant treatment of stage III and high-risk stage II colon cancer. J. Clin. Oncol. 23: 1819–1825.

    Article  PubMed  CAS  Google Scholar 

  • Prewett, M.C., Hooper, A.T., Bassi, R., Ellis, L.M., Waksal, H.W., and Hicklin, D.J. 2002. Enhanced antitumor activity of anti-epidermal growth fac tor receptor monoclonal antibody IMC-C225 in combination with irinotecan (CPT-11) against human colorectal tumor xenografts. Clin. Cancer Res. 8: 994–1003.

    PubMed  CAS  Google Scholar 

  • Ribic, C.M., Sargent, D.J., Moore, M.J., Thibodeau, S.N., French, A.J., Goldberg, R.M., Hamilton, S.R., Laurent-Puig, P., Gryfe, R., Shepherd, L.E., Tu, D., Redston, M., and Gallinger, S. 2003. Tumor microsatellite-instability status as a predictor of benefit from fluorouracil-based adjuvant chemotherapy for colon cancer. N. Engl. J. Med. 349: 247–257.

    Article  PubMed  CAS  Google Scholar 

  • Romero, R.Z., Morales, R., Garcia, F., Huarriz, M., Bandres, E., De la Haba, J., Gómez, A., Aranda, E., and García-Foncillas, J. 2006. Potential application of GSTT1-null genotype in predict ing toxicity associated to 5-fluouracil irinote-can and leucovorin regimen in advanced stage colorectal cancer patients. Oncol. Rep. 16(3): 497–503.

    PubMed  CAS  Google Scholar 

  • Saltz, L.B., Cox, J.V., Blanke, C., Rosen, L.S., Fehrenbacher, L., Moore, M.J., Maroun, J.A., Ackland, S.P., Locker, P.K., Pirotta, N., Elfring, G.L., and Miller, L.L. 2000. Irinotecan plus fluorouracil and leucovorin for metastatic color-ectal cancer. N. Engl. J. Med. 343: 905–914.

    Article  PubMed  CAS  Google Scholar 

  • Saltz, L.B., Clarke, S., Diaz-Rubio, E., Scheithauer, W, Figer, R, Wong, R, Koskis, S, Lichinister, M, Yang, T, and Cassidy, J. 2007. Bevacizumab (Bev) in combination with XELOX or FOLFOX: updated efficacy results from XELOX-1/ NO16966, a randomized phase III trial in first line metastatic colorectal cancer. J. Clin. Oncol. ASCO Annual Meeting Proceeding 25(170 s): 4028.

    Google Scholar 

  • Saunders, M.P., Hogg, M., Carrington, B., Sjursen, A.M., Allen, J., Beech, J., Swindell, R., and Valle, J.W. 2004. Phase I dose-escalating trial of irinotecan with continuous infusion 5-FU first line, in metastatic colorectal cancer. Br. J. Cancer 91: 1447–1452.

    PubMed  CAS  Google Scholar 

  • Seymour, M.T., Maughan, T.S., Ledermann, J.A., Topham, C., James, R., Gwyther, S.J., Smith, D.B., Shepherd, S., Maraveyas, A., Ferry, D.R., Meade, A.M., Thompson, L., Griffiths, G.O., Parmar, M.K., and Stephens, R.J., FOCUS Trial Investigators, National Cancer Research Institute Colorectal Clinical Studies Group. 2007. Different strategies of sequential and com bination chemotherapy for patients with poor prognosis advanced colorectal cancer (MRC FOCUS): a randomised controlled trial. Lancet 370(9582): 143–152.

    Article  PubMed  CAS  Google Scholar 

  • Shirota, Y., Stoehlmacher, J., Brabender, J., Xiong, Y.P., Uetake, H., Danenberg, K.D., Groshen, S., Tsao-Wei, D.D., Danenberg, P.V., and Lenz, H.J. 2001. ERCC1 and thymidylate synthase mRNA levels predict survival for colorectal cancer patients receiving combination oxaliplatin and fluorouracil chemotherapy. J. Clin. Oncol. 19: 4298–4304.

    PubMed  CAS  Google Scholar 

  • Souglakos, J., Mavroudis, D., Kakolyris, S., Kourousis, Ch., Vardakis, N., Androulakis, N., Agelaki, S., Kalbakis, K., Tsetis, D., Athanasiadis, N., Samonis, G., and Georgoulias, V. 2002. Triplet combination with irinotecan plus oxaliplatin plus continuous-infusion fluor-ouracil and leucovorin as first-line treatment in metastatic colorectal cancer: a multicenter phase II trial. J. Clin. Oncol. 20: 2651–2657.

    Article  PubMed  CAS  Google Scholar 

  • te Poele, R.H., and Joel, S.P. 1999. Schedule-dependent cytotoxicity of SN-38 in p53 wild-type and mutant colon adenocarcinoma cell lines. Br. J. Cancer 81(8): 1285–1293.

    Article  PubMed  CAS  Google Scholar 

  • Toffoli, G., Cecchin, E., Corona, G., Russo, A., Buonadonna, A., D'Andrea, M., Pasetto, L.M., Pessa, S., Errante, D., De Pangher, V., Giusto, M., Medici, M., Gaion, F., Sandri, P., Galligioni, E., Bonura, S., Boccalon, M., Biason, P., and Frustaci, S. 2006. The role of UGT1A1*28 polymorphism in the pharmacodynamics and pharmacokinetics of irinotecan in patients with metastatic colorectal cancer. J. Clin. Oncol. 24(19): 3061–3068.

    Article  PubMed  CAS  Google Scholar 

  • Tournigand, C., Andre, T., Achille, E., Lledo, G., Flesh, M., Mery-Mignard, D., Quinaux, E., Couteau, C., Buyse, M., Ganem, G., Landi, B., Colin, P., Louvet, C., and de Gramont, A. 2004. FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer: a ran domized GERCOR study. J. Clin. Oncol. 22: 229–237.

    Article  PubMed  CAS  Google Scholar 

  • Tsavaris, N., Kosmas, C., Skopelitis, H., Papadoniou, N., Polyzos, A., Zografos, G., Adoniou, E., Gryniatsos, J., Felekouras, E., Zacharakis, M., Sigala, F., Bacoyiannis, C., Papastratis, G., and Papalambros, E. 2007. Sequential administra tion of 5-fluorouracil (5FU)/leucovorin (LV) followed by irinotecan (CPT-11) at relapse ver sus CPT-11 followed by 5-FU/LV in advanced colorectal carcinoma. A phase III randomized study. Chemotherapy 53: 282–291.

    Article  PubMed  CAS  Google Scholar 

  • Van Cutsem, E., Nowacki, M., Lang, I., Cascinu, S., Shchepotin, I., Maurel, J., Rougier, P., Cunningham, D., Nippgen, J., and Köhne, C. 2007. Randomized phase III study of irinotecan and 5-FU/FA with or without cetuximab in the first-line treatment of patients with metastatic colorectal cancer (mCRC): the CRYSTAL trial. J. Clin. Oncol. ASCO Ann. Meet. Proc. 25(18 S): 4000.

    Google Scholar 

  • Venook, A. 2005. Clinical evaluation of cur rent treatments in metastatic colorectal cancer. Oncologist 10: 250–261.

    Article  PubMed  CAS  Google Scholar 

  • Wong, N.A., Brett, L., Stewart, M., Leitch, A., Longley, D.B., Dunlop, M.G., Johnston, P.G., Lessells, A.M., and Jodrell, D.I. 2001. Nuclear thymidylate synthase expression, p53 expression and 5FU response in colorectal carcinoma. Br. J. Cancer 85: 1937–1943.

    Article  PubMed  CAS  Google Scholar 

  • Yoshikawa, R., Kusunoki, M., Yanagi, H., Noda, M., Furuyama, J.I., Yamamura, T., and Hashimoto-Tamaoki, T. 2001. Dual antitumor effects of 5-fluorouracil on the cell cycle in colorectal car cinoma cells: a novel target mechanism concept for pharmacokinetic modulating chemotherapy. Cancer Res. 61: 1029–1037.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Springer Science + Business Media B.V.

About this chapter

Cite this chapter

Barone, C., Landriscina, M., Cassano, A. (2009). Colorectal Cancer: Optimization of the Combination of 5-Fluorouracil and Irinotecan. In: Hayat, M.A. (eds) Colorectal Cancer. Methods of Cancer Diagnosis, Therapy, and Prognosis, vol 4. Springer, Dordrecht. https://doi.org/10.1007/978-1-4020-9545-0_7

Download citation

  • DOI: https://doi.org/10.1007/978-1-4020-9545-0_7

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-1-4020-9544-3

  • Online ISBN: 978-1-4020-9545-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics