THE ROLE OF CHEMOTHERAPY AND ADJUVANT THERAPY IN THE MANAGEMENT OF COLORECTAL-CANCER

This review of the current literature related to the use of chemo- and adjuvant chemotherapy in colorectal carcinoma emphasizes the present dilemma in caring for people affected with this disorder. Adjuvant che motherapy using combinations of 5-fluorouracil and levamisole clearly prolong survival, albeit, for only a small group of individuals. Howev er, for the older person, this regimen may be associated with unaccept able toxicity and a physician's inability to deliver a dose-intensive course, as the authors currently understand it. Although quality of li fe is a clear concern of many older persons, little currently is avail able to evaluate this parameter during chemotherapy. It remains an imp ortant issue to address in the elderly person, because 35% of individu als found to have colorectal carcinoma are older than 65 years. Hopefu lly, better staging by incorporating molecular biologic techniques wil l assist in the effort to uncover the best regimens.