[Therapy of advanced colorectal cancer]

Despite new approaches, the long-term results of chemotherapy administered for advanced colorectal carcinoma continue to be unsatisfactory. In the case of a single local recurrent lesion, therefore, local measures (surgery +/- irradiation) are given preference. In the event of individual isolated liver metastases, an attempt should be made to resect them wherever possible. In the case of multi-site metastases, outside of trials, the decision to employ chemotherapy must be taken on an individual basis. Appropriate protocols on 5-fluorouracil monotherapy and on the modulation of the action of 5-fluorouracil by folic acid, are discussed. Since, to date, systemic chemotherapy has not proved able to cure colorectal carcinomas, every effort should be taken to avoid toxic side effects. By carefully selecting patients and treatment, at least some patients may benefit from a partial remission, arrest of disease progression and clinical improvement.