Adjuvant Therapy

New strategies addressing the postoperative and adjuvant therapy for colorectal cancer are evolving. The latest research has produced several new protocols. CPT-11 recently gained approval for colorectal cancer. There was an overall 18% response rate. In addition improvements to traditional therapy have been introduced with oxaliplatin added to 5-fluorouracil. Response rates of 46-69% have been demonstrated.

Postoperative radiation and chemotherapy for with transmural and/or node positive recal cancer has become standard. This has decreased local recurrence rates and improved overall disease free survival. A study from Memorial Sloan Kettering Cancer Center report preoperative radiation with 5-FU and leukovorin for patients with

resectable transmural lesions showed 22% complete clinical response. Sphincter preserving surgery was also possible in 85% of patients thought to require APR.

The NIH has recommended adjuvant therapy for Stage III colon and rectal cancers. This has shown a definite survival benefit as well as a reduction in recurrence. Use of adjuvant therapy for Stage II remains controversial.

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