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E-Updates: Controversies in the Management of Rectal Cancer 

Controversies in Preoperative Chemoradiation for Rectal Cancer


Medical Editor:
Bruce D. Minsky, MD
Associate Dean and Professor of Radiation and Cellular Oncology
Pritzker School of Medicine, University of Chicago
Chief Quality Officer
University of Chicago Medical Center
Chicago, Illinois

Authors:
Edward Chu, MD
Professor of Medicine and Pharmacology
Chief, Section of Medical Oncology
Deputy Director, Yale Cancer Center
Yale University School of Medicine
New Haven, Connecticut

Bruce D. Minsky, MD
Associate Dean and Professor of Radiation and Cellular Oncology
Pritzker School of Medicine, University of Chicago
Chief Quality Officer
University of Chicago Medical Center
Chicago, Illinois

Supported by an educational grant from Genentech BioOncology
2 AMA PRA Category 1 Credits™
| May 1, 2009



References
1. Gastrointestinal Tumor Study Group: Prolongation of the disease-free interval in surgically treated rectal carcinoma. N Engl J Med 312:1465-1472, 1985.

2. Fisher B, Wolmark N, Rockette H, et al: Postoperative adjuvant chemotherapy or radiation therapy for rectal cancer: Results from NSABP protocol R-01. J Natl Cancer Inst 80:21-29, 1988.

3. Krook JE, Moertel CG, Gunderson LL, et al: Effective surgical adjuvant therapy for high-risk rectal carcinoma. N Engl J Med 24:709-715, 1991.

4. Wolmark N, Wieand HS, Hyams DM, et al: Randomized trial of postoperative adjuvant chemotherapy with or without radiotherapy for carcinoma of the rectum: National Surgical Adjuvant Breast and Bowel Project Protocol R-02. J Natl Cancer Inst 92:388-396, 2000.

5. O'Connell MJ, Martenson JA, Wieand HS, et al: Improving adjuvant therapy for rectal cancer by combining protracted-infusion fluorouracil(Drug information on fluorouracil) with radiation therapy after curative surgery. N Engl J Med 33:502-507, 1994.

6. Smalley SR, Benedetti JK, Williamson SK, et al: Phase III trial of fluorouracil-based chemotherapy regimens plus radiotherapy in postoperative adjuvant rectal cancer: GI INT 0144. J Natl Cancer Inst 24:3542-3547, 2006.

7. Bosset JF, Collette L, Calais G, et al: Chemotherapy with preoperative radiotherapy in rectal cancer. N Engl J Med 355:1114-1123, 2006.

8. Collette L, Bosset JF, den Dulk M, et al: Patients with curative resection of cT3-4 rectal cancer after preoperative radiotherapy or radiochemotherapy: does anybody benefit from adjuvant fluorouracil-based chemotherapy? A trial of the European Organization for Research and Treatment of Cancer Radiation Oncology Group. J Natl Cancer Inst 25:4379-4386, 2007.

10. Gerard J, Conroy T, Bonnetain F, et al: Preoperative radiotherapy with or without concurrent fluorouracil and leucovorin in T3-4 rectal cancers: Results of FFCD 9203. J Natl Cancer Inst 24:4620-4625, 2006.

11. Benson AB, Catalan P, Meropol NJ, et al: ECOG E3201: Intergroup randomized phase III study of postoperative irinotecan(Drug information on irinotecan), 5-fluorouracil (FU), leucovorin (LV) (FOLFIRI) vs oxaliplatin(Drug information on oxaliplatin), FU/LV (FOLFOX) vs FU/LV for patients with stage II/III rectal cancer receiving either pre or postoperative radiation (RT)/FU (abstract 3526). J Natl Cancer Inst 24: 2006.

12. Benson AB: New approaches to assessing and treating early-stage colon and rectal cancers: Cooperative group strategies for assessing optimal approaches in early-stage disease. Clin Cancer Res 13(suppl 22): 6913s-6920s, 2007.

13. Andre T, Boni C, Mounedji-Boudiaf L, et al: Oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment for colon cancer. N Engl J Med 350:2343-2351, 2004.

14. Twelves C, Wong A, Nowacki MP, et al: Capecitabine(Drug information on capecitabine) as adjuvant treatment for stage III colon cancer. N Engl J Med 352:2696-2704, 2005.

 

 

Part 1: Is There a Role for Postoperative Chemotherapy?

 

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