The role of radiation therapy and 5-fluorouracil in colon and rectal cancer

Since the original report of improved survival of patients with locally unresectable gastric cancer treated with irradiation and 5-fluorouracil (5- FU) in 1968, there has been extensive investigation of this treatment combination in a variety of gastrointestinal tumors, including colon and rectal cancer. There are now extensive data supporting the use of 5-FU-based chemotherapy with irradiation in the adjuvant treatment of rectal cancer and increasing experience defining its role in neoadjuvant therapy. The value of adjuvant 5-FU-based chemotherapy and irradiation in colonic cancer is controversial, but there may be subsets of patients who benefit from this treatment. Ongoing studies in rectal and colon cancer are evaluating the role of irradiation with various modes of 5-FU administration {bolus v short or continuous infusion) as well as its modulation with other agents.