The role of chemotherapy and adjuvant therapy in the management of colorectal cancer.

This review of the current literature related to the use of chemo- and adjuvant chemotherapy in colorectal carcinoma emphasizes the present dilemma in caring for people affected with this disorder. Adjuvant chemotherapy using combinations of 5-fluorouracil and levamisole clearly prolong survival, albeit, for only a small group of individuals. However, for the older person, this regimen may be associated with unacceptable toxicity and a physician's inability to deliver a dose-intensive course, as the authors currently understand it. Although quality of life is a clear concern of many older persons, little currently is available to evaluate this parameter during chemotherapy. It remains an important issue to address in the elderly person, because 35% of individuals found to have colorectal carcinoma are older than 65 years. Hopefully, better staging by incorporating molecular biologic techniques will assist in the effort to uncover the best regimens.