Preoperative high-dose leucovorin/5-fluorouracil and radiation therapy for unresectable rectal cancer

Article Abstract:

Surgery remains the most important facet of treatment for rectal cancer. However, even when the tumor mass is removed completely, some residual cancer cells are likely to remain. Therefore, patients who receive chemotherapy after their surgery, or both chemotherapy and radiotherapy, have a better survival rate than do patients who were treated with surgery only. Unfortunately, the same cannot be said for patients with unresectable rectal cancer. When the cancer cannot be completely removed surgically, chemotherapy and radiotherapy are ineffective in preventing recurrence of the cancer. In roughly half of the cases that are initially not amenable to surgery, it may be possible to use radiotherapy prior to surgery to shrink an unresectable tumor to a size which may be surgically treated. A study was undertaken to determine if the combination of leucovorin and 5-fluorouracil chemotherapy with radiation therapy prior to surgery might result in improved survival. Twenty patients with unresectable rectal cancer were treated with this technique. All the patients had disease which did not appear to have spread from the pelvic area. A full 89 percent of the cancers treated with this combination therapy were then able to be treated surgically. At the time that the results were prepared for publication, the average follow-up time was 14 months. Since fewer than half the patients have died, it is not yet possible to report the median survival time. (Clearly, however, it will be longer than 14 months.) The results are encouraging, and research is underway to determine if a reduction in the dose of leucovorin and 5-fluorouracil could maintain the therapeutic effectiveness while decreasing the toxic effects. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Methods, Radiotherapy, Fluorouracil, Leucovorin, Folinic acid

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Hepatic arterial infusion of chemotherapy after resection of hepatic metastases from colorectal cancer

Article Abstract:

Patients with colorectal cancer that has spread to the liver may benefit from chemotherapy in addition to surgery. Researchers randomly assigned 156 patients with liver metastases from colorectal cancer to receive surgery and chemotherapy but in half the chemotherapy was infused directly into the major artery that supplies blood to the liver. Two years later, these patients had higher survival rates and higher rates of survival free of recurring cancer. Chemotherapy included floxuridine, dexamethasone, fluorouracil, and leucovorin.

Cancer metastasis, Chemotherapy, Liver cancer

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