[Progress in adjuvant and palliative chemotherapy of colorectal cancer: current status and perspectives]

After 3 decades of intense investigation some important advances have been made in the management of patients with colorectal cancer. Adjuvant chemotherapy trials in colon cancer have indicated a significant decrease in recurrence and a prolongation of survival when 5-fluorouracil (5-FU) plus levamisole are administered to patients with potentially curable tumour which has, however, spread to locoregional lymph nodes. Recent trials in stage II and III rectal cancer have demonstrated a comparable advantage for postoperative adjuvant 5-FU combined with radiation therapy. In the setting of metastatic disease, both in the presence and absence of clinical symptoms, it seems also likely that certain palliative regimens integrating biochemical modulation of 5-FU will result in a survival benefit without affecting the quality of life. According to continuing worldwide, interdisciplinary and cooperative study efforts, further improvements in current standard treatment approaches are likely to be achieved in the near future.