Adjuvant therapy in rectal cancer: a protocol proposal

The use of adjuvant radiation therapy and chemotherapy diminishes the likelihood of local-regional and distant recurrences and appears to prolong survival in patients who have undergone a complete surgical resection of a Dukes-Kirklin stage B2 or C rectal cancer. Patients with this malignant condition rarely develop peritoneal recurrences and therefore do not seem to be an appropriate group in which to evaluate the efficacy of intraperitoneal chemotherapy in gastrointestinal cancer. Such individuals, however, might serve as ideal subjects to examine objectively the merits of prolonged, ambulatory infusional chemotherapy through a prospective clinical trial comparing postoperative radiation therapy combined with 5-FU given in either protracted continuous infusional or intermittent bolus schedules.