title: Feasibility of image-guided radiotherapy for elderly patients with locally advanced rectal cancer.
abstract: OBJECTIVE
  The study aims to assess the tolerance of elderly patients (70 years or older) with locally advanced rectal cancers to image-guided radiotherapy (IGRT). A retrospective review of 13 elderly patients with locally advanced rectal cancer who underwent preoperative chemoradiation using IGRT was performed. Grade 3-4 acute toxicities, survival, and long-term complications were compared to 17 younger patients (<70 years) with the same disease stage.
  
  
  RESULTS
  Grade 3-4 hematologic toxicities occurred in 7.6% and 0% (p = 0.4) and gastrointestinal toxicities, and, in 15.2% and 5% (p = 0.5), of elderly and younger patients, respectively. Surgery was aborted in three patients, two in the elderly group and one in the younger group. One patient in the elderly group died after surgery from cardiac arrhythmia. After a median follow-up of 34 months, five patients had died, two in the elderly and three in the younger group. The 3-year survival was 90.9% and 87.5% (p = 0.7) for the elderly and younger group respectively. Two patients in the younger group developed ischemic colitis and fecal incontinence. There was no statistically significant difference in acute and late toxicities as well as survival between the two groups.
  
  
  CONCLUSIONS
  Elderly patients with locally advanced rectal cancers may tolerate preoperative chemoradiation with IGRT as well as younger patients. Further prospective studies should be performed to investigate the potential of IGRT for possible cure in elderly patients with locally advanced rectal cancer.
authors: Department of Radiation Oncology, University of Arizona, Tucson, Arizona, USA. NamPhong.Nguyen@yahoo.com
authors: Nam P
authors: NP
authors: Nguyen
authors: Misty
authors: M
authors: Ceizyk
authors: Jacqueline
authors: J
authors: Vock
authors: Paul
authors: P
authors: Vos
authors: Alexander
authors: A
authors: Chi
authors: Vincent
authors: V
authors: Vinh-Hung
authors: Judy
authors: J
authors: Pugh
authors: Rihan
authors: R
authors: Khan
authors: Christina
authors: C
authors: Truong
authors: Gabby
authors: G
authors: Albala
authors: Angela
authors: A
authors: Locke
authors: Ulf
authors: U
authors: Karlsson
authors: Steve
authors: S
authors: Gelumbauskas
authors: Lexie
authors: L
authors: Smith-Raymond
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D061089:Radiotherapy, Image-Guided / Q000009:adverse effects; D012004:Rectal Neoplasms / Q000473:pathology* / Q000532:radiotherapy* / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome
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