Adjuvant Chemotherapy for Rectal Cancer After Neoadjuvant Treatment

FOLFOX, 5-FU, or Observation

Research output: Contribution to journalReview article

Abstract

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.

Original languageEnglish (US)
Pages (from-to)260-265
Number of pages6
JournalCurrent Colorectal Cancer Reports
Volume12
Issue number5
DOIs
StatePublished - Oct 1 2016

Fingerprint

Neoadjuvant Therapy
Adjuvant Chemotherapy
Rectal Neoplasms
Fluorouracil
Observation
oxaliplatin
Drug Therapy
Practice Management
Therapeutics
Colonic Neoplasms
Radiotherapy
Randomized Controlled Trials
Survival

Keywords

  • Adjuvant chemotherapy
  • Neoadjuvant chemoradiation
  • Rectal cancer
  • Survival

ASJC Scopus subject areas

  • Hepatology
  • Oncology
  • Gastroenterology

Cite this

@article{5dc4736633f245b3aae8f1abe6fb881c,
title = "Adjuvant Chemotherapy for Rectal Cancer After Neoadjuvant Treatment: FOLFOX, 5-FU, or Observation",
abstract = "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.",
keywords = "Adjuvant chemotherapy, Neoadjuvant chemoradiation, Rectal cancer, Survival",
author = "Daniel Ahn and Tanios Bekaii-Saab",
year = "2016",
month = "10",
day = "1",
doi = "10.1007/s11888-016-0332-7",
language = "English (US)",
volume = "12",
pages = "260--265",
journal = "Current Colorectal Cancer Reports",
issn = "1556-3790",
publisher = "Springer Science + Business Media",
number = "5",

}

TY - JOUR

T1 - Adjuvant Chemotherapy for Rectal Cancer After Neoadjuvant Treatment

T2 - FOLFOX, 5-FU, or Observation

AU - Ahn, Daniel

AU - Bekaii-Saab, Tanios

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

UR - http://www.scopus.com/inward/record.url?scp=84982908257&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84982908257&partnerID=8YFLogxK

U2 - 10.1007/s11888-016-0332-7

DO - 10.1007/s11888-016-0332-7

M3 - Review article

VL - 12

SP - 260

EP - 265

JO - Current Colorectal Cancer Reports

JF - Current Colorectal Cancer Reports

SN - 1556-3790

IS - 5

ER -