Pharmacotherapy of colon, rectosigmoid junction and rectal cancer

Summary

Colon, rectosigmoid junction and rectal carcinoma is a very common disease in Europe, especially in the Czech Republic. Pharmacotherapy of the disease is indicated in neoadjuvant and adjuvant settings as well as in palliative therapy.

Standard adjuvant therapy regimens include 5-fluorouracil (5-FU) with leucovorin, capecitabine in monotherapy, the FOLFOX combination (5-FU, leucovorin, oxaliplatin), and the FLOX combination. Neoadjuvant therapy is indicated in stage T3 rectal cancers and in patients with clinically positive lymph nodes. It is administered concomitantly with radiotherapy. The dominant objective of palliative pharmacotherapy for metastatic disease is to render the condition operable, i.e. to make the resection of the metastatic disease possible. Patients eligible for the resection of the metastatic disease have significantly better prognosis.

The main emphasis in the process of determining the treatment procedure for patients with colorectal cancer is close cooperation of a team of physicians – diagnosticians, surgeons, oncologists and radiotherapists. The team of specialists should have adequate experience and rely on a well-equipped workplace with adequate hospital complement background.

Key words:
colon, rectosigmoid junction and rectal carcinomas, adjuvant therapy, palliative therapy