Adjuvant therapy for colorectal carcinoma: An overview

Over the past two decades, significant progress has occurred in adjuvant treatment of colorectal cancer. Clinical trials continue to attempt to resolve a variety of questions including die optimal route of administration of chemotherapy (intravenous vs intraportal), the most effective combination of chemotherapeutic agents, the appropriate use of combined modality therapy, and expected toxicity vs benefit. In addition, newer agents, including monoclonal antibodies, are being investigated in an ongoing attempt to reduce the recurrence rate following 'curative' resection. Results of recently completed trials are awaited, but adjuvant chemotherapy with 5-fluorouracil and levamisole has shown success in improving survival in Dukes C colon cancer, whilst combination chemotherapy and radiotherapy seems to reduce recurrence rates and increase survival in rectal cancer.