Adjuvant Chemotherapy in Large-Bowel Cancer: Demonstration of Effectiveness of Single Agent Chemotherapy in a Prospectively Controlled, Randomized Trial

Abstract

Combining surgical resection and chemotherapy in the treatment of neoplasms has a sound biologic basis, and application of this principle has resulted in striking improvement in survival rates for a variety of malignancies, particularly in pediatric solid neoplasms. Large-scale cooperative, prospectively controlled trials combining surgical treatment with adjuvant chemotherapy in the management of bowel cancer date back to 1967 and have been reviewed elsewhere [5, 8]. Most of these trials have not shown that the addition of chemotherapy has increased the disease-free interval and survival with the exception of the most recent Veterans Administration Surgical Adjuvant Group trial employing prolonged, intermittent treatment with 5-fluorouracil (5-FU) in which there is definite suggestion of treatment benefit in those patients receiving chemotherapy [2, 7–10, 15]. Evaluation of the treatment results in the Central Oncology Group trial (COG 7041) have been reported in the past and have consistently shown definite improvement in the duration of the disease-free interval and recurrence rate, particularly in certain unfavorable subgroups of patients with colorectal carcinoma [4–6]. This report is an update of the Central Oncology Group (COG) trial as of May 1978.

This work was supported by Central Oncology Group Grants CA-12282 and CA-12271 and the Cancer Education Program Grant CA-19527 from the USPHS, National Cancer Institute.