Chemo-diversion strategy for unresectable colorectal carcinoma: report of two cases

The concept of treatment for unresectable colorectal carcinoma consists of surgical treatment, chemotherapy, and radiotherapy. Especially, the aim of surgical intervention is reduction of tumor volume and reconstruction of intestinal continuity, and both of them have been done simultaneously until recently. Two patients with unresectable colorectal carcinoma showed marked response to Pharmacokinetic modulating chemotherapy (PMC) modified using leucovorin and CPT-11. In these cases, modified PMC including radiotherapy to diminish residual tumor cells, facilitated reconstruction of intestinal continuity several months after the initial surgery. In other words, the initial volume reduction surgery might have contributed to eliciting the marked effects of chemotherapy. A two-stage chemo-diversion strategy using modified PMC may be a new treatment concept for initially unresectable colorectal carcinoma allowing a possible cure.