Francesca De Felice1, Karen Llange2, Filippo Rubini2, Nadia Bulzonetti2, Rossella Caiazzo2, Daniela Musio2, Vincenzo Tombolini3. 1. Department of Radiotherapy, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy. Electronic address: fradefelice@hotmail.it. 2. Department of Radiotherapy, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy. 3. Department of Radiotherapy, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy; Spencer-Lorillard Foundation, Rome, Italy.
Abstract
INTRODUCTION: We report the treatment compliance, toxicity rates, and long-term clinical outcomes of elderly patients who received intensified neoadjuvant chemoradiotherapy (CRT) for locally advanced rectal cancer (LARC). PATIENTS AND METHODS: We identified a retrospective cohort of patients aged ≥ 70 years with LARC who received intensified neoadjuvant CRT, followed by surgery and adjuvant chemotherapy, from 2007 to 2014. Intensified neoadjuvant CRT consisted of radiotherapy (total dose, 50.4/54 Gy) with concomitant oxaliplatin (50 mg/m2/wk) and 5-fluorouracil (200 mg/m2 in 5 daily continuous infusion). RESULTS: A total of 26 patients were included. All patients completed the programmed CRT. Severe acute toxicity was recorded in 19.2% of cases. Conservative surgery was performed in 16 patients, and a pathologic complete response was achieved in 19.2%. Overall, 26.9% of the patients died. The 5-year overall survival and disease-free survival rates were 70.6% and 65.5%, respectively. CONCLUSIONS: Intensified neoadjuvant CRT is an efficacious and safe treatment option for LARC in elderly patients.
INTRODUCTION: We report the treatment compliance, toxicity rates, and long-term clinical outcomes of elderly patients who received intensified neoadjuvant chemoradiotherapy (CRT) for locally advanced rectal cancer (LARC). PATIENTS AND METHODS: We identified a retrospective cohort of patients aged ≥ 70 years with LARC who received intensified neoadjuvant CRT, followed by surgery and adjuvant chemotherapy, from 2007 to 2014. Intensified neoadjuvant CRT consisted of radiotherapy (total dose, 50.4/54 Gy) with concomitant oxaliplatin (50 mg/m2/wk) and 5-fluorouracil (200 mg/m2 in 5 daily continuous infusion). RESULTS: A total of 26 patients were included. All patients completed the programmed CRT. Severe acute toxicity was recorded in 19.2% of cases. Conservative surgery was performed in 16 patients, and a pathologic complete response was achieved in 19.2%. Overall, 26.9% of the patients died. The 5-year overall survival and disease-free survival rates were 70.6% and 65.5%, respectively. CONCLUSIONS: Intensified neoadjuvant CRT is an efficacious and safe treatment option for LARC in elderly patients.