TY - JOUR
T1 - Determining therapeutic approaches in the elderly with rectal cancer
AU - Pasetto, Lara Maria
AU - Basso, Umberto
AU - Friso, Maria Luisa
AU - Pucciarelli, Salvatore
AU - Agostini, Marco
AU - Rugge, Massimo
AU - Sinigaglia, Giulietta
AU - Lise, Mario
AU - Sotti, Guido
AU - Monfardini, Silvio
PY - 2007/9/13
Y1 - 2007/9/13
N2 - 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.
AB - 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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U2 - 10.2165/00002512-200724090-00006
DO - 10.2165/00002512-200724090-00006
M3 - Article
C2 - 17727307
AN - SCOPUS:34548481780
VL - 24
SP - 781
EP - 790
JO - Drugs and Aging
JF - Drugs and Aging
SN - 1170-229X
IS - 9
ER -