Adjuvant chemotherapy is of definite value in
Ans. is 'a' i.e. CA colon Harrison writes - "Chemotherapy can be administered as an adjuvant, i.e., in addition to surgery or radiation, after all clinically apparent disease has been removed. This use of chemotherapy may have curative potential in breast and colorectal neoplasms, as it attempts to eliminate clinically unapparent tumor that may have already disseminated." Devita' Oncology writes-" Several well-conducted randomized phase 3 clinical studies have documented efficacy of adjuvant chemotherapy in prolonging disease freeand overall survival in patients with breast cancer, colon cancer, gastric cancer, non small-cell lung cancer, ovarian cancer, head and neck cancer, and cervical cancer, Wilms' tumor, and osteogenic sarcoma. There is also evidence to suppo the use of adjuvant chemotherapy in patients with Anaplastic astrocytomas. Patients with primary malignant melanoma at high risk of metastases derive benefit in terms of improved disease-free survival and overall survival from adjuvant treatment with the biologic agent interferon-I+- although this treatment must be given for 1 year for optimal clinical efficacy. Finally, the antiestrogens tamoxifen and anastrozole are effective adjuvant agents in postmenopausal women whose breast tumors express the estrogen receptor." Adjuvant Chemotherapy: Indicated for (Ref- Devita's Oncology) Anaplastic astrocytoma Osteogenic sarcoma Breast cancer Pancreatic cancer Colorectal cancer Ovarian cancer Gastric cancer Head and neck cancer Melanoma Cervical cancer Non small cell lung cancer Wilm's tumor (Note that Harrison 17/e table 81.1 lists only 4 cancers for adjuvant therapy i.e. --Breast, colon, osteogenic sarcoma and soft tissue sarcoma) Also know: Primary induction chemotherapy refers to drug therapy administered as the first treatment for patients who present with advanced cancer for which no alternative treatment exists. This approach applies for patients with advanced, metastatic disease. Cancer chemotherapy can be curative in a small but significant subset of patients who present with advanced disease. In adults, these curable cancers include- Hodgkin's and non-Hodgkin's lymphoma, acute lymphoblastic and myelogenous leukemia, germ cell cancer, ovarian and localized small-cell lung cancers, and choriocarcinoma. In pediatric patients. the major curable cancers include - acute leukemias, Burkitt's lymphoma, Wilms' tumor, and embryonal rhabdomyosarcoma.
CA colon
CA pancreas
CA gall bladder
CA oesophagus