Is there evidence to support routine use of adjuvant chemotherapy for resected rectal cancer treated with pre-operative chemoradiation?
The NCCN seems to make its recommendation based on extrapolation from colon cancer, but those patients are not treated with pre-op chemoRT.
Answer from: Medical Oncologist at Academic Institution
We settled this question in 1985 with the GITSG study showing chemo, or radiation were better than observation and the combination had the best survival (GITSG, NEJM 312,1465, 1985). Whether you administer radiation or systemic therapy before or after surgery is irrelevant but all three modalities h...
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Answer from: Radiation Oncologist at Academic Institution
I know of no evidence (certainly no level 1 evidence exists) attesting to a benefit to adjuvant therpaies (chemotherapy in particular). The decision to include adjuvant chemotherapy was based purely on the theory that the neoadjuvant chemotherapy dose and drug selection was inadequate to provide for...