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Adjuvant therapy of rectal cancer, including stage II

Posted Dec 14 2009 6:36am

Adjuvant chemotherapy for Stage II colon cancer is controversial but the field is now returning back to it and guideliens stae taht it si optional but accepted. There is greater acceptance for rectal cancer and NCCN lists Folfox or capecitabine for adjuvant therapy of rectal cancer on p.7 of rectal cancer guidelines. In rectal cancer, there is remaining uncertainty regarding preoperative versus postoperative treatment, ot both, and guidelines provide guidance in either situation. The one randomized study in the USA, R-03, that looked at the question found both approaches to be comparable. A German study is ongoing, with 800 patients. Both regimens incorporate four cycles of 5-day 5-FU administered in the postoperative setting.

Roh MS, Petrelli N, Wieand S, et al: Phase III randomized trial of preoperative versus postoperative multimodality therapy in patients with carcinoma of the rectum (NSABP R-03) (abstract 490). Proc Am Soc Clin Oncol 20:123a, 2001.

Camma C, Giunta M, Fiorica F, et al: Preoperative radiotherapy for resectable rectal cancer: A meta-analysis. JAMA 284:1008-1015, 2000., rectal

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