TY - JOUR
T1 - Adjuvant Chemotherapy for Rectal Cancer After Neoadjuvant Treatment
T2 - FOLFOX, 5-FU, or Observation
AU - Ahn, Daniel H.
AU - Bekaii-Saab, Tanios
N1 - Publisher Copyright:
© 2016, Springer Science+Business Media New York.
PY - 2016/10/1
Y1 - 2016/10/1
N2 - A multimodality approach incorporating concurrent chemotherapy with radiotherapy prior to surgery has become the standardized approach in the management of localized rectal cancer. However, it is unknown whether any further therapy after surgery may be beneficial in improving patient outcomes. Previous completed randomized clinical trials have not added any clarity in this regard, whether adjuvant chemotherapy or intensified chemotherapy regimens improve patient outcomes in those who have previously received neoadjuvant therapy. Despite the lack of evidence, based off the survival data in stage III colon cancer, adjuvant chemotherapy has become a standardized practice in the management of resected rectal cancer. Furthermore, recommendations include the consideration of added oxaliplatin to adjuvant therapy in this disease. While it is unclear whether all patients should receive adjuvant chemotherapy, a subset of patients, including those who achieve a pathologic response may benefit from further treatment. Ongoing studies utilizing an individualized, stepwise multimodality approach may define the role of adjuvant therapy and the appropriate regimen in patients with resected rectal cancer.
AB - A multimodality approach incorporating concurrent chemotherapy with radiotherapy prior to surgery has become the standardized approach in the management of localized rectal cancer. However, it is unknown whether any further therapy after surgery may be beneficial in improving patient outcomes. Previous completed randomized clinical trials have not added any clarity in this regard, whether adjuvant chemotherapy or intensified chemotherapy regimens improve patient outcomes in those who have previously received neoadjuvant therapy. Despite the lack of evidence, based off the survival data in stage III colon cancer, adjuvant chemotherapy has become a standardized practice in the management of resected rectal cancer. Furthermore, recommendations include the consideration of added oxaliplatin to adjuvant therapy in this disease. While it is unclear whether all patients should receive adjuvant chemotherapy, a subset of patients, including those who achieve a pathologic response may benefit from further treatment. Ongoing studies utilizing an individualized, stepwise multimodality approach may define the role of adjuvant therapy and the appropriate regimen in patients with resected rectal cancer.
KW - Adjuvant chemotherapy
KW - Neoadjuvant chemoradiation
KW - Rectal cancer
KW - Survival
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U2 - 10.1007/s11888-016-0332-7
DO - 10.1007/s11888-016-0332-7
M3 - Review article
AN - SCOPUS:84982908257
SN - 1556-3790
VL - 12
SP - 260
EP - 265
JO - Current Colorectal Cancer Reports
JF - Current Colorectal Cancer Reports
IS - 5
ER -