Locoregional chemotherapy for adjuvant treatment of colorectal adenocarcinoma.
Adjuvant chemotherapy with 5-fluorouracil (5-FU) and levamisole administered intravenously for 1 year has proved to be effective after curative surgical resection of Dukes' stage C colon carcinomas. Locoregional chemotherapy aims at delivering drugs directly into the abdominal cavity or the liver using either intraperitoneal or intraportal route of administration. Theoretically, these routes of administration have several advantages. The drugs can be delivered at a high dose concentration to the most common site of recurrence (i.e. peritoneum and liver) with decreased systemic toxicity. This article reviews the present status of intraportal and intraperitoneal chemotherapy as adjuvant postoperative treatment for colorectal carcinoma with special attention to the results of prospective randomised trials. Some positive results confirm that both route of administration represent promising methods for adjuvant chemotherapy. However, currently there are insufficient data on which to make a clear-cut conclusion on real benefits. New trials are currently in progress to test new modalities using different drugs or different drug combinations, using both locoregional and systemic treatments, and may prove to be more effective than systemic chemotherapy alone in the adjuvant treatment of colorectal cancers.
Penna
C
C
Department of Gastrointestinal Surgery, Hospital Saint-Antoine, Paris, France.
Nordlinger
B
B
D000230:Adenocarcinoma / Q000188:drug therapy*; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D005472:Fluorouracil / Q000008:administration & dosage*; D006801:Humans; D007262:Infusions, Intravenous; D007263:Infusions, Parenteral; D016032:Randomized Controlled Trials as Topic
D000964:Antimetabolites, Antineoplastic; D005472:Fluorouracil