Application of radiotherapy in perioperative comprehensive treatment for the elderly with rectal cancer

Abstract

Considered that most of the phase II or III clinical trials contain less elderly patients or only contain those who had good health status, these results might not be applied in those elderly patients with some complex status. The patients of 70 years old or more usually have complications or worse organ function, thus the standard treatment for them becomes a gray zone. In rectal cancer patients, the rate of elderly patients receiving standard chemoradiotherapy (CRT) is obviously lower than that of the younger ones. More and more retrospective studies found that the prognosis of the elderly (≥70) who received neo-adjuvant or adjuvant CRT was better than that of those who received surgery or radiotherapy only, and the outcome of the above-mentioned elderly was similar to those of other phase III trial or younger patients with good tolerance. In addition, some studies revealed patients with good status, less or slight complications had a better prognosis. The advance of radiation therapy, such as Image-guided Radiation Therapy (IGRT), Intensity-modulated Radiation Therapy (IMRT), Stereotactic Body Radiation Therapy (SBRT), brachytherapy and particle therapy, will benefit the elderly cancer patients. We think that treatments recommended to the elderly will become more personalized.