Literature DB >> 17483785

Preoperative radiotherapy in elderly patients with rectal cancer.

Fabrice Lorchel1, Karine Peignaux, Gilles Créhange, Mathieu Bosset, Marc Puyraveau, Mariette Mercier, Jean-François Bosset, Philippe Maingon.   

Abstract

PURPOSE: We performed a retrospective analysis in order to evaluate the compliance with preoperative radiotherapy in patients aged>or=70 with locally advanced resectable rectal cancer, and to evaluate the influence of comorbidities on treatment tolerance and oncological results.
METHODS: From March 1984 to December 2000, 95 patients with T3-T4 N0 M0 rectal cancer received a preoperative radiotherapy in 2 radiotherapy departments. Nineteen patients received concomitant chemotherapy.
RESULTS: All patients completed the radiation schedule. Six patients suffered grade 3 acute WHO toxicity. Surgical resection was performed in 87 patients. There were 3 post-operative deaths. Analysis of peri-operative complications showed thromboembolism (4.9%), ileus (9.8%) and diarrhoea (6.1%). After a median follow-up of 29 months, the 3- and 5-year overall survival rates were 65% and 49% respectively. In univariate analysis, a tumour located in the mid part of the rectum, a radiation dose less than 40 Gy, the absence of chemotherapy were significantly associated with a poor prognosis. There was a trend to a better survival for patients with a Charlson score of 0 (P=0.0584). In multivariate analysis, only initial WHO performance status was significant.
CONCLUSIONS: Compliance with preoperative radiotherapy is good in elderly patients. Toxicity rates are similar to those described in randomised trials in which only younger patients were included. Initial WHO performance status<or=1 is significantly associated with better survival.

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Year:  2007        PMID: 17483785     DOI: 10.1016/s0399-8320(07)89407-3

Source DB:  PubMed          Journal:  Gastroenterol Clin Biol        ISSN: 0399-8320


  6 in total

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Review 5.  Management of locally advanced rectal cancer in the elderly: a critical review and algorithm.

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  6 in total

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