The aim of this systematic review was to determine the optimal duration of chemotherapy. Currently, the standard of duration is based upon studies performed in the 90's, and focus on the determination of the best schedule of 5FU treatment alone or in combination with folinic acid or levamisole and the optimal duration of the adjuvant treatment. Different durations of 5FU based treatment were compared: 6 months versus 9-12 months. Shorter duration of chemotherapy (3-6 months) compared with longer duration (9-12 months) did not result in poorer relapse free survival or overall survival. Consequently, the duration of 5FU based chemotherapy in adjuvant setting for colorectal cancer can be reduced to 6 months.
A recently published study compared 3 months continuous infusion of 5FU to 6 months bolus 5FU, and showed the benefit of this 3 months schedule. Therefore, future studies will evaluate the efficacy of shorter chemotherapy with the new gold-standard: FOLFOX (combining oxaliplatine and 2 days continuous 5FU, bimonthly) in order to minimize the neurotoxicity of oxaliplatine.