What is the role of chemotherapy and radiation therapy in the treatment of pediatric colorectal tumors?

Updated: Jun 06, 2020
  • Author: Jaime Shalkow, MD, FACS; Chief Editor: Cameron K Tebbi, MD  more...
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Answer

Answer

Radiation is often given with or without chemotherapy in the neoadjuvant setting for rectal cancer, to reduce the risk of local recurrence.

Adjuvant chemotherapy may be considered for recurrence risk reduction in stage III or high-risk stage II CRC. Features that indicate a high risk of recurrence in stage II CRC include the following:

  • Peritoneal tumor infiltration (T4)
  • High grade
  • Perforation or obstruction at presentation
  • Lymphovascular or perineural invasion
  • Inadequate lymph node sampling

Combination chemotherapy with a fluoropyrimidine and oxaliplatin for 6 months remains the standard of care, although studies show little difference between 3 and 6 months of therapy in the absence of T4 or heavy lymph node involvement.

After surgery and adjuvant therapy, surveillance monitoring for recurrence includes periodic clinical assessment, CT, colonoscopy, and measurement of CEA levels.


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