Chemotherapy and cancer of the gastrointestinal tract

Less than 40 percent of all carcinomas of the gastrointestinal tract will be controlled by the current modalities of treatment. Early diagnosis and appropriate surgical resection are still the only rational and effective approach to the control of this cancer. The tremendous strides in cancer chemotherapy in the management of leukemia, children's solid tumors, and neoplasms of lymphoid origin have not been evident in the management of gastrointestinal carcinoma. Extensive clinical trials with single agents and various drug combinations have resulted so far in partial response rates. Adjuvant chemotherapy to surgical resection has also failed to alter the natural course of the disease and, therefore, to establish its benefits in a series of projective randomized studies. Only continued research in cancer cell biology and basic and clinical pharmacology with carefully controlled therapeutic trials with new agents will eventually lead to the more effective use of chemotherapy in management of gastrointesinal cancer.