Adjuvant chemotherapy

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Adjuvant chemotherapy is a term used to describe the role of chemotherapy relative to other cancer treatments.

The terms adjuvant and neoadjuvant have special meanings in oncology. Adjuvant therapy refers to additional treatment, usually given after surgery where all detectable disease has been removed, but where there remains a statistical risk of relapse due to occult disease. If known disease is left behind following surgery, then further treatment is not technically "adjuvant".

For example, radiotherapy or chemotherapy is commonly given as adjuvant treatment after surgery for a breast cancer. Oncologists use statistical evidence to assess the risk of disease relapse before deciding on the specific adjuvant therapy. The aim of adjuvant treatment is to improve disease-specific and overall survival. Because the treatment is essentially for a risk, rather than for provable disease, it is accepted that a proportion of patients who receive adjuvant therapy will already have been cured by their primary surgery.

Adjuvant chemotherapy and radiotherapy are often given following surgery for many types of cancer, including colon cancer, lung cancer, pancreatic cancer, breast cancer, prostate cancer, and some gynaecological cancers.

Neoadjuvant therapy, in contrast to adjuvant therapy, is given before the main treatment. For example, chemotherapy that is given before removal of a breast is considered neoadjuvant chemotherapy. The most common reason for neoadjuvant therapy is to reduce the size of the tumor so as to facilitate more effective surgery.

Finally, concomitant or concurrent chemotherapy refers to administering medical treatments at the same time as other therapies, such as radiation.