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Determining Therapeutic Approaches in the Elderly with Rectal Cancer

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Abstract

Background

To evaluate the toxicity and feasibility of pelvic radiotherapy (RT) and/or surgery in elderly patients with locally advanced low-lying rectal cancer.

Patients and methods

From November 1999 to November 2005, 51 patients aged ≥70 years who underwent RT for locally advanced low-lying rectal cancer were retrospectively examined. Variables considered were age, co-morbidities (evaluated according to the Charlson score and the Cumulative Illness Rating Scale-Geriatric [CIRS-G] score) and surgery versus no surgery.

Results

The median age was 80 years (range 70–94 years) and the male: female ratio was 33: 18. A total of 5.9% of patients were considered ‘fit’, 72.5% had one or more CIRS-G grade 1 or 2 co-morbidities and 21.6% had one or more CIRS-G grade 3 co-morbidities. 54.9% of patients underwent surgery and 45.1% underwent RT. Only 9 of 21 (42.8%) patients who underwent radical resection received the full course of adjuvant RT and only seven (50%) of all patients treated with RT alone received the full dose of therapy. Patients with one or more CIRS-G grade 3 co-morbidities reported similar numbers of grade 1–2 toxicities as patients with one or more CIRS-G grade 2 co-morbidities.

Conclusion

Notwithstanding the small number of patients analysed, the findings of this study indicate that elderly patients with rectal cancer and mild comorbidities could probably receive the same treatment as fit elderly patients, given that tolerability appeared to be similar in both categories of patients. Neither age nor co-morbidities should be considered reasons to deny the patient the possible benefits of receiving complete treatment. Moreover, Multidimensional Geriatric Assessment should always be undertaken to help clinicians make better decisions about treatment. Further prospective trials are needed to confirm these results.

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Acknowledgements

No sources of funding were used to assist in the preparation of this study. The authors have no conflicts of interest that are directly relevant to the content of this study.

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Authors and Affiliations

  1. Oncologia Medica 2nd, Istituto Oncologico Veneto, Via Gattamelata 64, 35128, Padova, Italy

    Lara Maria Pasetto, Umberto Basso & Silvio Monfardini

  2. Department of Radiotherapy, Istituto Oncologico Veneto, Padova, Italy

    Maria Luisa Friso & Guido Sotti

  3. 2nd Surgical Clinic, Azienda Ospedale-Università, Padova, Italy

    Salvatore Pucciarelli, Marco Agostini & Mario Lise

  4. Department of Pathology, Istituto Oncologico Veneto, Padova, Italy

    Massimo Rugge

  5. Farmacologia Sperimentale e Clinica, CRO, Aviano, PN, Italy

    Giulietta Sinigaglia

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  1. Lara Maria Pasetto
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  2. Umberto Basso
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  3. Maria Luisa Friso
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  4. Salvatore Pucciarelli
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  8. Mario Lise
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  9. Guido Sotti
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  10. Silvio Monfardini
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Correspondence to Lara Maria Pasetto.

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Pasetto, L.M., Basso, U., Friso, M.L. et al. Determining Therapeutic Approaches in the Elderly with Rectal Cancer. Drugs Aging 24, 781–790 (2007). https://doi.org/10.2165/00002512-200724090-00006

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  • DOI: https://doi.org/10.2165/00002512-200724090-00006

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