Gastrointestinal cancer—colon (surgery-radiotherapy).The role of radiation therapy in the management of rectosigmoid cancer

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Abstract
The lack of an improvement in the gross survival statistics for colorectal cancer during the last decade and the negative results of randomized trials, suggests that 5-FU used as an adjuvant treatment has not increased survival. Current chemotherapeutic drug combinations, however, may prove effective in the adjuvant situation. The adjuvant use of preoperative radiation has shown improved survival in one randomized study and no change in the second study. Current preoperative radiotherapy studies using a more effective radiation dose will confirm the effect of preoperative radiation both on the primary tumor control and on metastases. Current postoperative adjuvant trials incorporating radiation, chemotherapy or a combination of the two, when completed, will provide clear indications for the physician as to the optimum treatment of Duke's B and C cancer of the colorectum. Three national randomized studies for inoperable, recurrent or residual carcinoma of the colorectum are testing the effect of radiation alone or in combination with chemotherapy or chemotherapy followed by immunotherapy.