Nonsurgical management of recurrent colorectal cancer.

Abstract:

:Most patients with colorectal carcinoma undergo attempts at curative surgery. However, some present with metastatic disease and many others ultimately relapse. Most recurrences of colorectal cancer are not resectable and require nonsurgical approaches such as chemotherapy and radiation therapy directed against local recurrences, hepatic metastases, and widely disseminated disease. Nonsurgical therapy for locoregional recurrence of rectal cancer can offer significant palliation. Intraarterial chemotherapy for liver metastases increases the likelihood of response compared to systemic treatments, but has little effect on survival. Extrahepatic progression and hepatic toxicity are important limitations to this regional therapy. 5-fluorouracil (5-FU) is the mainstay of systemic chemotherapy, and efforts to modulate biochemically the cytotoxic effects of 5-FU with folinic acid, phosphonacetyl-L-aspartate, interferon, and other agents have resulted in promising response rates. The different approaches to biochemical modulation are being studied in ongoing cooperative group trials. Novel approaches, including monoclonal antibody therapy, biologic modifier therapy, and gene therapy, are under investigation.

journal_name

Cancer

journal_title

Cancer

authors

Vaughn DJ,Haller DG

doi

10.1002/1097-0142(19930615)71:12+<4278::aid-cncr28

subject

Has Abstract

pub_date

1993-06-15 00:00:00

pages

4278-92

issue

12 Suppl

eissn

0008-543X

issn

1097-0142

journal_volume

71

pub_type

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