Skip to content

Colorectal Cancer Health Center

Font Size

Rectal Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage III Rectal Cancer

Treatment options:

  1. Preoperative chemoradiation with fluorouracil (5-FU) for patients with clinically staged T3 or T4 rectal adenocarcinoma.
  2. Total mesorectal excision (TME) with either low anterior resection (LAR) or abdominoperineal resection (APR).
  3. Postoperative chemoradiation for patients with stage II or III rectal cancer who did not receive preoperative chemoradiation.
  4. Four to six months of 5-FU-based chemotherapy postoperatively.
  5. A clinical trial.

Prior to the standard use of preoperative chemoradiation for stage II and III rectal cancer, several studies established the benefits of adjuvant combined-modality therapy for surgical stage II and III disease. Intergroup protocol 86-47-51 (MAYO-864751) demonstrated a 10% improvement in overall survival (OS) with the use of continuous-infusion 5-FU (225 mg/m2 /day throughout the course of radiation therapy) compared with bolus 5-FU (500 mg/m2 /day for 3 consecutive days during the first and fifth weeks of radiation).[1][Level of evidence: 1iiA] The final results of Intergroup trial 0114 (CLB-9081) showed no survival or local-control benefit with the addition of leucovorin (LV), levamisole, or both to 5-FU administered postoperatively for stage II and III rectal cancers at a median follow-up of 7.4 years.[2][Level of evidence: 1iiA]

Recommended Related to Colorectal Cancer

Understanding Colorectal Cancer -- Prevention

To help prevent colorectal cancer, eat plenty of fresh fruits and vegetables; cut back on red meat and other high-fat foods, such as eggs and many dairy products. You can get the protein you need from low-fat dairy products (also a good source of calcium), nuts, beans, lentils, and soybean products. Calciumsupplements have also been shown in some trials to modestly reduce the risk of colon cancer. Avoid overcooking or barbecuing meats and fish. Eat a diet rich in cereal fiber or bran and yellow and...

Read the Understanding Colorectal Cancer -- Prevention article > >

Another study, INT-0144 (NCT00002551), was a three-arm randomized trial designed to determine whether continuous-infusion 5-FU throughout the entire standard six-cycle course of adjuvant chemotherapy was more effective than continuous 5-FU only during pelvic radiation and included the following:[3][Level of evidence: 1iiA]

  • Arm 1 received bolus 5-FU in two 5-day cycles before (500 mg/m2 /day) and after (450 mg/m2 /day) radiation therapy, with protracted venous infusion 5-FU (225 mg/m2 /day) during radiation therapy.
  • Arm 2 received continuous infusion 5-FU before (300 mg/m2 /day for 42 days), after (300 mg/m2 /day for 56 days), and during (225 mg/m2 /day) radiation therapy.
  • Arm 3 received bolus 5-FU/LV in two 5-day cycles before (5-FU 425 mg/m2 /day; LV 20 mg/m2 /day) and after (5-FU 380 mg/m2 /day; LV 20 mg/m2 /day) radiation therapy, and bolus 5-FU/LV (5-FU 400 mg/m2 /day; LV 20 mg/m2 /day; days 1 to 4, every 28 days) during radiation therapy. Levamisole (150 mg/day) was administered in 3-day cycles every 14 days before and after radiation therapy.
    1|2|3
    Next Article:

    Today on WebMD

    Colorectal cancer cells
    The right diagnosis is the most important factor.
    man with a doctor
    Our health check will steer you in the right direction.
     
    sauteed cherry tomatoes
    Fight cancer one plate at a time.
    bladder cancer x-ray
    Do you know the warning signs?
     
    bread
    ARTICLE
    Colon vs Rectal Cancer
    VIDEO
     
    New Colorectal Treatments
    VIDEO
    can lack of sleep affect your immune system
    FEATURE
     
    Cancer Facts Quiz
    QUIZ
    Virtual Colonoscopy
    VIDEO
     
    Picture of the Colon
    ANATOMY
    Vitamin D
    SLIDESHOW