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

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.Cancer 40:595-603,1977 ARCINOMA OF T H E SICMOID COLON A N D REC-C tum requires a multimodality team for optimum care. Since an increase in the survival rate is the ultimate objective, all factors affecting the mortality rate of the disease must be recognized and quantitated in studies involving multimodality treatment. This paper will briefly review the epidemiology, incidence, etiology and screening procedures for carcinoma of the colon since they affect the clinical stage at'presentation. The importance of staging and a knowledge of areas of failure will be discussed and the factors affecting the cancer cure rate due to surgery and radiation will be presented. Incidence, Epidemiology and EtiologyCancer of the colon and rectum has the highest cancer incidence and is the cause of the second highest cancer mortality rate in the