title: Effects of preoperative radiochemotherapy with capecitabine for resectable locally advanced rectal cancer in elderly patients.
abstract: OBJECTIVE
  Rectal cancer is a common disease of elderly people. However, patients over 70 years of age are often not included in clinical trials. There is a lack of data concerning the use of radiochemotherapy with capecitabine in elderly patients. The aim of this study was to retrospectively evaluate the impact of preoperative radiochemotherapy with capecitabine on downstaging and sphincter preservation and to assess treatment compliance and toxicity in elderly patients.
  
  
  METHODS
  Twenty-six patients with resectable locally advanced rectal cancer (stage II-III/TNM) aged >70 years received preoperative radiotherapy and concurrent oral capecitabine 825 mg/m² twice daily during the whole period of radiotherapy. Two patients who refused surgery after chemoradiation therapy were excluded from the analysis. Results. Eighty-one percent of patients underwent anterior resection and 18.1% underwent abdominoperineal resection. Overall tumor downstaging, considering both T and N categories, was observed in 18/24 patients (75%). Treatment compliance was good and toxicity rates were similar to those of younger people.
  
  
  CONCLUSIONS
  Age is not a contraindication to any therapy and elderly patients who can tolerate radiochemotherapy should be treated like younger patients. Preoperative radiochemotherapy with capecitabine for patients aged >70 years has a good impact on tumor downstaging, increases the feasibility of sphincter-preserving surgery, and is also safe and well tolerated.
authors.affiliation: Radiation Oncology Department, G d’Annunzio University, SSAnnunziata Hospital, Via dei Vestini, Chieti, Italy.
authors.forename: Giampiero
authors.initials: G
authors.lastname: Ausili Cèfaro
authors.forename: Domenico
authors.initials: D
authors.lastname: Genovesi
authors.forename: Annamaria
authors.initials: A
authors.lastname: Vinciguerra
authors.forename: Antonietta
authors.initials: A
authors.lastname: Augurio
authors.forename: Monica
authors.initials: M
authors.lastname: Di Tommaso
authors.forename: Rita
authors.initials: R
authors.lastname: Marchese
authors.forename: Valentina
authors.initials: V
authors.lastname: Borzillo
authors.forename: Lucia
authors.initials: L
authors.lastname: Tasciotti
authors.forename: Maria
authors.initials: M
authors.lastname: Taraborrelli
authors.forename: Paolo
authors.initials: P
authors.lastname: Innocenti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Colecchia
authors.forename: Marta
authors.initials: M
authors.lastname: Di Nicola
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000601:surgery; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use*; D000069287:Capecitabine; D059248:Chemoradiotherapy / Q000009:adverse effects; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D020360:Neoadjuvant Therapy / Q000379:methods*; D009367:Neoplasm Staging; D012004:Rectal Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil