title: Preoperative chemoradiotherapy in elderly patients with locally advanced rectal cancer.
abstract: OBJECTIVE
  To evaluate the treatment tolerance and clinical outcomes in patients aged 70 and older with locally advanced rectal carcinoma treated with multimodality approach.
  
  
  METHODS
  We retrospectively analysed 20 consecutive elderly patients, with histologically proven rectal adenocarcinoma, staged T3-4, and/or node-positive tumour, who received chemoradiotherapy and proceeded to surgical approach. Performance status score and adult comorbidity evaluation-27 score were calculated, and their influence on treatment tolerance and clinical outcomes was analysed.
  
  
  RESULTS
  All patients completed programmed chemoradiotherapy treatment. Gastrointestinal toxicity was the most common acute side effects: proctitis in 70% of patients and diarrhoea in 55%, classified as Grade 3 in 3 patients only. Radiation dermatitis was reported in 7 patients (35%) and it was graded G3 in one patient. There was no haematological toxicity. Eighteen patients out of 20 underwent surgery. Sphincter preservation was assured in 13 patients. Comorbidity index was related to higher severe acute toxicity (P = 0.015) but no influenced treatment outcomes.
  
  
  CONCLUSIONS
  Treatment tolerance with combined modality is good in elderly patients. Due to age, no dose reduction for radiation therapy and chemotherapy should be considered.
authors.affiliation: Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Viale Regina Elena 326, 00161 Rome, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: De Felice
authors.affiliation: Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Viale Regina Elena 326, 00161 Rome, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Musio
authors.affiliation: Department of Surgery "Pietro Valdoni", Policlinico Umberto I "Sapienza" University of Rome, Viale Regina Elena 326, 00161 Rome, Italy.
authors.forename: Luciano
authors.initials: L
authors.lastname: Izzo
authors.affiliation: Department of Surgery "Pietro Valdoni", Policlinico Umberto I "Sapienza" University of Rome, Viale Regina Elena 326, 00161 Rome, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Pugliese
authors.affiliation: Department of Surgery "Pietro Valdoni", Policlinico Umberto I "Sapienza" University of Rome, Viale Regina Elena 326, 00161 Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Izzo
authors.affiliation: Department of Surgery "Pietro Valdoni", Policlinico Umberto I "Sapienza" University of Rome, Viale Regina Elena 326, 00161 Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Bolognese
authors.affiliation: Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Viale Regina Elena 326, 00161 Rome, Italy ; Spencer-Lorillard Foundation, Viale Regina Elena 262, 00161 Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Tombolini
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D064420:Drug-Related Side Effects and Adverse Reactions / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology; D009367:Neoplasm Staging; D011300:Preoperative Care; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D012189:Retrospective Studies; D016896:Treatment Outcome