Oncologic Outcome and Morbidity in the Elderly Rectal Cancer Patients After Preoperative Chemoradiotherapy and Total Mesorectal Excision

Abstract

Although acute hematologic toxicity was observed more frequently in the elderly patients than that in the younger patients, elderly rectal cancer patients with good performance status who received preoperative CRT and TME showed favorable tumor response and recurrence-free survival similar to younger patients.

Neoadjuvant chemoradiotherapy or radiotherapy in patients aged 75 years or older with locally advanced rectal cancer

“…Our study reported that the 3-year and estimated 5-year DSS, DFS and LC for patients receiving multimodal therapy were 75.8% and 60.4%, 68.2% and 56.1%, 83.9% and 78.3%, respectively. These results were quite comparable to the previous studies regarding elderly patients [12,[20][21][22]29]. Notably, the oncologic outcomes of our study were not inferior than younger patients in other studies [2,15,21].…”

“…In the study of ACCOR 12/PRODICE 2 phase III trial [12], the incidence of severe grade 3/4 preoperative chemoradiotherapy related toxicity in elderly patients (≥70 years) was 25.6%, while it was only 15.8% in younger patients (<70 years). A case-matched control study from Korea also showed higher rate of G3+ acute hematologic toxicity in elderly patients (≥70 years), compared with that in patients younger than 70 years (16.1% vs 9.0%) [21]. In our study, nine patients (16.1%) developed G3/4 neoadjuvant treatment related toxicities, which was comparable with the above studies.…”

“…These results were quite comparable to the previous studies regarding elderly patients [12,[20][21][22]29]. Notably, the oncologic outcomes of our study were not inferior than younger patients in other studies [2,15,21]. In the study of FFCD 9203 [2], the reported 5-year progression free survival (PFS) and local recurrence rate (LRR) were 59.4% and 8.1%.…”

“…The pCR rate was 21.4%, which was consistent with the previous meta-analysis [23]. Another propensity-score matching analysis [21] reported that the pCR rate wasn't significantly different between elderly and younger patients (14.8% vs 17.1%, P=0.433). Obviously, elderly patients can also get benefit from dose escalation radiotherapy as their younger counterparts do.…”

“…Many studies have reported the incidence of neoadjuvant chemoradiotherapy related toxicity in elderly patients with LARC [12,[19][20][21][22]. Tougeron D, et al [20] retrospectively evaluated safety of chemoradiotherapy in 125 patients with LARC over 70 years, about 15% of enrolled patients developed G3+ adverse events.…”