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Adjuvant Therapy

Adjuvant chemotherapy for colon cancer is, in the United States, advised routinely for patients found to have involved lymph nodes (Dukes C or stage 3 disease). Local and distant recurrences develop in 30 to 50% of these patients. Standard chemotherapy today includes 5-fluorouracil (5-FU) and levamisole (Ergamisol) (or leucovorin), although many other agents, including irinotecan (CPT-11), are currently being evaluated in clinical trials. In this setting, adjuvant chemotherapy is usually given for 6 to 9 months.

For patients with T3 or node-positive rectal cancers who did not undergo preoperative radiotherapy, postoperative radiotherapy (usually 4500 to 5400 cGy) combined with chemotherapy (6 to 9 months) has been shown to increase significantly length of survival and decrease local recurrence rates. Patients with node-positive high rectal cancers (tumor above the peritoneal reflection) are usually advised to undergo chemotherapy alone.


Sarah J. Thompson, MD


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