title: [Tolerance and efficacy of preoperative radiation therapy for elderly patients treated for rectal cancer].
abstract: OBJECTIVE
  To retrospectively assess the impact of age on tolerance and oncologic outcomes treated by neoadjuvant treatment for patients of 70 years old or above with locally advanced rectal cancer.
  
  
  METHODS
  Ninety-one consecutive patients were divided into three groups: group 1 from 70 to 75 years (n=31); group 2: 76 to 79 years (n=31) and group 3, patients aged 80 years or above (n=29). Radiation therapy was delivered according two schemes: 25Gy in five fractions (short scheme) or 45 to 50Gy with a classical fractionation (long scheme). Long scheme patients received a concomitant chemotherapy with 5-fluoro-uracile alone or associated with oxaliplatin.
  
  
  RESULTS
  The three groups were comparable for performance status, Charlson's score and T staging. Long scheme radiation therapy and chemotherapy were performed in 77.5, 74.5 and 48.3% of patients (P=0.03) and 77.4, 71 and 41.4% (P=0.006) in the groups 1, 2 and 3, respectively. All patients treated with the short scheme irradiation received the treatment without any acute toxicity. In the long scheme group, 65% of patients received the treatment on time and grade 3 or above toxicity was observed in 12% of patients who did not receive oxaliplatin and in 48% of patients who received oxaliplatin. The overall survival rate at 3 and 5 years was 66.9% and 60.8% in the group 1, 90.5% and 75.9% in the group 2 and 80.5% and 73.8% in the group 3 (P=0.15).
  
  
  CONCLUSIONS
  Neoadjuvant treatment is feasible with encouraging survival rates for patients aged 70 years and older. Short scheme radiation therapy seems to be an interesting option in this population.
authors: Service de radiothérapie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France. emmanuelle.lefur@chu-brest.fr
authors: E
authors: E
authors: Le Fur
authors: G
authors: G
authors: Chatellier
authors: A
authors: A
authors: Berger
authors: J-F
authors: JF
authors: Emile
authors: B
authors: B
authors: Dousset
authors: B
authors: B
authors: Nordlinger
authors: O
authors: O
authors: Berges
authors: M
authors: M
authors: Deberne
authors: B
authors: B
authors: Dessard-Diana
authors: M
authors: M
authors: Henni
authors: P
authors: P
authors: Giraud
authors: M
authors: M
authors: Housset
authors: C
authors: C
authors: Durdux
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D019583:Dose Fractionation, Radiation; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D000077150:Oxaliplatin; D012004:Rectal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D005472:Fluorouracil