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. 2013:2013:610786.
doi: 10.1155/2013/610786. Epub 2013 Dec 12.

Preoperative chemoradiotherapy in elderly patients with locally advanced rectal cancer

Francesca De Felice  1 , Daniela Musio  1 , Luciano Izzo  2 , Federico Pugliese  2 , Paolo Izzo  2 , Antonio Bolognese  2 , Vincenzo Tombolini  3
Affiliations

Preoperative chemoradiotherapy in elderly patients with locally advanced rectal cancer

Francesca De Felice et al. Biomed Res Int. 2013.

Abstract

Purpose: To evaluate the treatment tolerance and clinical outcomes in patients aged 70 and older with locally advanced rectal carcinoma treated with multimodality approach.

Methods and materials: We retrospectively analysed 20 consecutive elderly patients, with histologically proven rectal adenocarcinoma, staged T3-4, and/or node-positive tumour, who received chemoradiotherapy and proceeded to surgical approach. Performance status score and adult comorbidity evaluation-27 score were calculated, and their influence on treatment tolerance and clinical outcomes was analysed.

Results: All patients completed programmed chemoradiotherapy treatment. Gastrointestinal toxicity was the most common acute side effects: proctitis in 70% of patients and diarrhoea in 55%, classified as Grade 3 in 3 patients only. Radiation dermatitis was reported in 7 patients (35%) and it was graded G3 in one patient. There was no haematological toxicity. Eighteen patients out of 20 underwent surgery. Sphincter preservation was assured in 13 patients. Comorbidity index was related to higher severe acute toxicity (P = 0.015) but no influenced treatment outcomes.

Conclusion: Treatment tolerance with combined modality is good in elderly patients. Due to age, no dose reduction for radiation therapy and chemotherapy should be considered.

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References

    1. Gunderson LL, Sargent DJ, Tepper JE, et al. Impact of T and N substage on survival and disease relapse in adjuvant rectal cancer: a pooled analysis. International Journal of Radiation Oncology Biology Physics. 2002;54(2):386–396. - PubMed
    1. Schmoll HJ, Van Cutsem E, Stein A, et al. ESMO Consensus Guidelines for management of patients with colon and rectal cancer. a personalized approach to clinical decision making. Annals of Oncology. 2012;23(10):2479–2516. - PubMed
    1. Rödel C, Liersch T, Becker H, et al. Preparative chemoradiotherapy and postoperative chemotherapy with fluorouracil and oxaliplatin versus fluorouracil alone in locally advanced rectal cancer: initial results of the German CAO/ARO/AIO-04 randomised phase 3 trial Rectal Cancer Study Group. The Lancet Oncology. 2012;13:679–687. - PubMed
    1. Aschele C, Cionini L, Lonardi S, et al. Primary tumor response to preoperative chemoradiation with or without oxaliplatin in locally advanced rectal cancer: pathologic results of the STAR-01 randomized phase III trial. Journal of Clinical Oncology. 2011;29(20):2773–2780. - PubMed
    1. Gérard J-P, Azria D, Gourgou-Bourgade S, et al. Comparison of two neoadjuvant chemoradiotherapy regimens for locally advanced rectal cancer: results of the phase III trial accord 12/0405-Prodige 2. Journal of Clinical Oncology. 2010;28(10):1638–1644. - PubMed

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