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Locally Advanced Rectal Cancer: Treatment Approach in Elderly Patients

Authors
  • De Felice, Francesca1
  • Crocetti, Daniele2
  • Maiuri, Veronica1
  • Parisi, Martina1
  • Marampon, Francesco1
  • Izzo, Luciano2
  • De Toma, Giorgio2
  • Musio, Daniela1
  • Tombolini, Vincenzo1
  • 1 Policlinico Umberto I, “Sapienza” University of Rome, Viale Regina Elena 326, Rome, 00161, Italy , Rome (Italy)
  • 2 Policlinico Umberto I, “Sapienza” University of Rome, Rome, Italy , Rome (Italy)
Type
Published Article
Journal
Current Treatment Options in Oncology
Publisher
Springer US
Publication Date
Jan 11, 2020
Volume
21
Issue
1
Identifiers
DOI: 10.1007/s11864-019-0692-8
Source
Springer Nature
Keywords
License
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Abstract

Independently of age, evidence-based guidelines recommend a multidisciplinary treatment approach in patients with locally advanced rectal cancer (LARC). But actually, elderly patients are grossly underrepresented in clinical trials, accounting < 10% of enrolled cases. Therefore, LARC management in elderly patients remains a crucial issue in daily practice, especially due to their frailty. Multiple clinical factors, including general health status, cognitive status, co-morbidity, disability, and life expectancy should be considered to understand the complexities of geriatric assessment and then define therapy. We use a patient-centered approach in order to tailor the optimal treatment strategy. We treat fit elderly patients as younger patients, including neoadjuvant chemoradiotherapy (CRT), surgery, and adjuvant chemotherapy. Whereas, in vulnerable and frail patients, we propose standard CRT (vulnerable patients) or radiotherapy alone (frail patients).

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