Erschienen in:
01.01.2020 | Lower Gastrointestinal Cancers (AB Benson, Section Editor)
Locally Advanced Rectal Cancer: Treatment Approach in Elderly Patients
verfasst von:
Francesca De Felice, PhD, Daniele Crocetti, PhD, Veronica Maiuri, MD, Martina Parisi, MD, Francesco Marampon, PhD, Luciano Izzo, FP, Giorgio De Toma, FP, Daniela Musio, MD, Vincenzo Tombolini, FP
Erschienen in:
Current Treatment Options in Oncology
|
Ausgabe 1/2020
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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).