NCCN Guidelines for Patients® | Colon Cancer - page 52

1
About colon cancer
Genetic counseling | Treatment
NCCN Guidelines for Patients
®
Colon Cancer, Version 1.2014
50
6.1 Surgical options for recurrent colon cancer
Chart 6.1.1 Option 1
starts with surgery. A
metastasectomy can be followed by chemotherapy.
FOLFOX and CapeOX are preferred regimens. Other
possible regimens are FLOX, capecitabine, and 5-FU/
LV. Six months of chemotherapy is preferred.
Chart 6.1.2 Option 2
starts with treating the
metastases with chemotherapy. FOLFOX and
CapeOX are preferred regimens. Other possible
regimens are FLOX, capecitabine, and 5-FU/LV.
After 2 to 3 months of chemotherapy, a
metastasectomy may be done. Treatment after
surgery is based on the success of treatment before
surgery. If the treatment before surgery worked,
you may re-start that treatment or take FOLFOX.
Together, chemotherapy given before and after
surgery should not exceed 6 months. If the treatment
before surgery didn’t work, you can start a treatment
regimen in Part 7 or start observation. Observation is
a period of testing to assess for cancer growth.
6
Treatment guide
Surgical ptions for recurrent colon cancer
If you have
never
had chemotherapy before, there are two options.
Chart 6.1.1 Option 1
Primary treatment
Adjuvant treatment
• Metastasectomy
• FOLFOX or CapeOX, or
• FLOX or Capecitabine or 5-FU/LV
Chart 6.1.2 Option 2
Neoadjuvant treatment
Primary treatment
Adjuvant treatment
• FOLFOX or CapeOX,
• FLOX,
• Capecitabine, or
• 5-FU/LV
• Metastasectomy
• If neoadjuvant worked:
– Re-start neoadjuvant regimen, or
– FOLFOX
• If neoadjuvant didn’t work:
– Treatment in Part 7, or
– Observation
1...,42,43,44,45,46,47,48,49,50,51 53,54,55,56,57,58,59,60,61,62,...88
Powered by FlippingBook