Colorectal Cancer Chemotherapy Regimens

Colorectal Cancer Chemotherapy Regimens
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Colorectal cancer is a type of cancer that begins in the rectum or large intestine. In the United States, this type of cancer is the number one cause of cancer-related deaths. Chemotherapy is a common form of treatment for this type of cancer. There are several different colorectal cancer chemotherapy regimens that the patient’s doctor will choose from to treat the patient’s cancer.

Mayo Clinic Regimen (Adjuvant)

This regimen involves administering low-dose leucovorin plus intensive-course fluorouracil. Studies show that this regimen is effective in improving a patient’s survival rate and preventing tumor relapse when the patient has a high-risk colorectal cancer. Both of these benefits were noticeable after the patient’s received just six cycles of treatment. This regimen is typically given on an outpatient basis. The most common chemotherapy toxicities were diarrhea, stomatitis, and leukopenia.

Roswell Park Memorial Institute Regimen (Adjuvant)

This regimen involves administering leucovorin-modulated fluorouracil. Studies show that approximately 73 percent of patients fell into the three-year disease-free survival rate. When these patients attended their three-year follow-up their mortality rate was reduced by 32 percent and their treatment failure development risk was reduced by 30 percent.

Mayo Clinic Regimen (Advanced)

This colorectal cancer chemotherapy regimen involves administering leucovorin and fluorouracil to advanced metastatic colorectal cancer patients. The weekly regimen caused more patients to need to be hospitalized and to experience diarrhea than the intensive-course regimen. The intensive-course regimen caused more stomatitis and leukopenia than the weekly regimen. Low-dose leucovorin plus intensive-course fluorouracil seems to have a far more superior therapeutic index than high-dose leucovorin plus weekly fluorouracil.

Conventional Chemotherapy

Conventional chemotherapy for metastatic colorectal cancer are:

  • 5-fluorouracil which can be given intravenously (there is also an orally active form)
  • Irinotecan which is administered intravenously
  • Oxaliplatin which is administered intravenously

These chemotherapies help to fight colorectal cancer by working to prevent and/or stop cancer cells from reproducing or dividing.

Targeted Chemotherapy

This type of chemotherapy involves using a type of protein, known as antibodies, to help fight cancer by preventing a specific protein that is necessary for colon cancer cells to survive and/or grow. Targeted chemotherapies include:

  • Bevacizumab
  • Panitumumab
  • Cetuximab

Possible Side Effects

The combination, type, and drug schedules will determine the side effects experienced by a patient. Some patients handle chemotherapy for colorectal cancer very well while others do not. Possible side effects may include:

  • Mouth soreness
  • Blood cell counts temporarily lowered
  • Diarrhea
  • Hair loss
  • Fatigue
  • Hand and feet tingling
  • Being sensitive to cold temperatures
  • Gastrointestinal tract bleeding
  • Skin rash
  • Heart rhythm abnormalities
  • Weakness
  • Low blood levels of magnesium, calcium, or potassium
  • Hand-foot syndrome

Patients who experience side effects that are bothersome should speak to their doctor because their doctor may be able to offer ways to help them control these side effects.

Resources

DoctorsLounge. (2007). Cancer Chemotherapy Regimens: Cancer of the Colon. Retrieved on November 15, 2010 from DoctorsLounge: https://www.doctorslounge.com/oncology/regimens/colon/

UpToDate. (2010). Patient Information: Colorectal Cancer Treatment; Metastatic Cancer. Retrieved on November 15, 2010 from UpToDate: https://www.uptodate.com/patients/content/topic.do?topicKey=~uySy4hv7M03My