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Annals of Oncology 12:13-22, 2001
© 2001 European Society for Medical Oncology


review-article

Adjuvant treatment of colorectal cancer at the turn of the century: European and US perspectives

J. Wils1, P. O'Dwyer2 and R. Labianca3

1Oncology Unit, Si Laurentius Hospital Roermond, The Netherlands
2University of Pennsylvania-PMC Philadelphia, Pennsylvania. USA
3Riuniti Hospital, Unit of Medical Oncology Bergamo. Italy

J Wils, MD Oncology Unit St Laurentius Hospital 6043 CN Roermond The Netherlands E-mail wils{at}mail.cobweb.nl

BACKGROUND: Despite early scepticism, several studies of systemic adjuvant 5-fluorouracil (5-FU)-based chemotherapy demonstrated significant benefits in high-risk colon cancer As many clinical investigations have since been conducted in this setting, a comprehensive literature review was undertaken to clarify the role of adjuvant therapy in the treatment of colorectal cancer

DESIGN: Current and future adjuvant treatment approaches in colorectal cancer were reviewed, and differences in the present-day North American and European practices were highlighted.

RESULTS AND CONCLUSIONS: 5-FU plus leucovonn for six months is generally considered the ‘standard’ adjuvant treatment in Dukes' stage C (stage III) colon cancer Large-scale international trials of other strategies are required to provide further advances in treatment outcome Following the lead of the USA Intergroup trials, a recently initiated cooperative effort, the Pan-European Trials in Adjuvant Colon Cancer (PETACC), may serve as a European model for such investigations In T3 and/or lymph-node positive rectal cancer, postoperative (chemo)radiotherapy in the USA is considered the adjuvant treatment of choice However, most European investigators have advocated for preoperative intensive short-course irradiation instead Randomized trials inthis area are ongoing. In the near future, new drugs for the treatment of colorectal cancer maylead to tailored therapies

adjuvant treatment, coloreclal cancer, PETACC


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