Rectal cancer neoadjuvant treatment in elderly patients

Lara Maria Pasetto, Maria Luisa Friso, Salvatore Pucciarelli, Umberto Basso, Cristina Falci, Alberto Bortolami, Paola Toppan, Marco Agostini, Massimo Rugge, Samantha Serpentini, Donato Nitti, Silvio Monfardini

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Abstract

Background: The aim of the study was to evaluate the differences in terms of toxicity and feasibility of neoadjuvant 5-fluorouracil (5FU) continuous infusion (c.i.) or bolus in combination with pelvic radiotherapy (RT) in locally advanced rectal cancer "fit" or "vulnerable" elderly patients. A secondary endpoint was to identify any specific comorbidity that affected either effectiveness or morbidity of treatment. Patients and Methods: From June 2000 to June 2005, 36 patients over 70 years of age out of a total of 88 consecutive elderly cases were retrospectively examined. Variables considered were age, gender, modality of 5FU administration and comorbidities (evaluated according to Cumulative Illness Rating Scale-Geriatric, CIRS-G). Results: Median age was 74 years (range, 70-82) years and the male:female ratio, 22:14. Fourteen % of the patients healthy and 25% with slight comorbidities were considered "fit" and 61% "vulnerable". All the patients received the full course of RT. The mean number of chemotherapy weeks was 5.34 (range, 2-6); "vulnerable" patients did not experience higher toxicity compared to "fit" patients (p=0.69). Eighty-nine % of the patients were operated without relevant postoperative complications. Thirteen out of 20 "vulnerable" and 10 out of 12 "fit" patients had a pathological downstaging of disease (p=0.24). Conclusion: Selected elderly "vulnerable" patients with rectal cancer can receive the same neoadjuvant 5FU-based chemoradiotherapy (either bolus or c.i.) and undergo surgery as well as "fit" elderly patients, since tolerability and response rate seem to be similar in both categories of patients.

Original languageEnglish
Pages (from-to)3913-3923
Number of pages11
JournalAnticancer Research
Volume26
Issue number5 B
Publication statusPublished - Sep 2006

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Keywords

  • Elderly
  • Neoadjuvant chemotherapy
  • Rectal cancer

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Pasetto, L. M., Friso, M. L., Pucciarelli, S., Basso, U., Falci, C., Bortolami, A., Toppan, P., Agostini, M., Rugge, M., Serpentini, S., Nitti, D., & Monfardini, S. (2006). Rectal cancer neoadjuvant treatment in elderly patients. Anticancer Research, 26(5 B), 3913-3923.