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KMID : 0869620100270020139
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Journal of Korean Society of Hospital Pharmacists
2010 Volume.27 No. 2 p.139 ~ p.151
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The Review of Chemotheraphy in Colorectal Cancer
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Bang Eun-Mi
Park Yun-Hee
Kim Won-Kyu
Lim Keum-Sook
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Abstract
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Colorectal cancer is the third most frequently diagnosed cancer in Korea (2007). It is the third leading cause of cancer death in men and the forth leading cause of cancer death in women. The mortality from colorectal cancer has increased slightly over the past 10 years for the westernization of Korean diet. But the survival rate is increasing with endoscopic surgery and chemotherapy regimens including a VEGF(Vascular Endotherial Growth Factor) inhibitor or an EGFR(Epidermal Growth Factor Receptor) inhibitor. The objective of the study is to review and evaluate the adjuvant chemotherapy after surgery and the chemotherapy of advanced or metastatic disease by NCCN(National Comprehensive Cancer Network) guideline in oncology (for colon cancer) V.2.2010. We reviewed retrospectively the EMR of 29 patients who had received adjuvant chemotherapy after surgery from January 2007 to December 2009. The use of adjuvant chemotherapy for patients with stage II colon cancer is controversal. The adjuvant therapy with FOLFOX, 5-FU/LV or capecitabine is recommended for patients with stage III disease, and as an option for patients with high-risk stage II disease by NCCN guideline. And irinotecan-containing regimens should not be used as adjuvant therapy in colon cancer. All of the patients with stage II lesions were received LF regimen regardless of risk-based stage in NPH(National Police
Hospital). The use of irinotecan-containing regimens(IFL or FOLFIRI) as adjuvant therapy in 3 cases of 21 cases is not appropriated(14.3%). Recommended initial therapy options for advanced or metastatic disease depend on whether or not the patient is appropriate for intensive therapy. And chemotherapy options for patients with progressive disease are dependent on the choice of initial therapy. The use of IFL regimen for advanced disease is no longer recommended for its toxicity and is removed from the guideline. However we found that 5 cases of 9 patients in advanced or metastatic disease were received IFL regimen. Therefore, it is recommended that the use of IFL regimen for advanced disease should be limited.
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KEYWORD
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colorectal cancer, adjuvant chemotherapy, chemotherapy of advanced or metastati disease
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