Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.
Private Practice of Radiation Oncology, Hannover, Germany.
Anticancer Res. 2019 Nov;39(11):6217-6222. doi: 10.21873/anticanres.13830.
BACKGROUND/AIM: Elderly cancer patients are more prevalent and require special attention. This study focused on the outcome of elderly (≥65 years) rectal cancer patients treated with tri-modality therapy.
A total of 105 patients receiving neoadjuvant radio-chemotherapy and resection for locally advanced rectal cancers were retrospectively evaluated. Nine characteristics were analyzed for loco-regional control (LRC), metastases-free survival (MFS) and overall survival (OS) including tumor location, gender, age, performance status, radiotherapy technique, primary tumor/lymph node categories, downstaging and histological grading.
The 5-year rates of LRC, MFS and OS were 91%, 78% and 87%, respectively. Radio-chemotherapy was not completed in 12 patients (11%) due to toxicity; 18 patients (17%) experienced grade 3 toxicities. A total of 29 patients (28%) had surgical complications. On multivariate analyses, MFS was significantly associated with downstaging (p=0.003) and OS with lower histological grade (p=0.013).
Tri-modality therapy resulted in promising outcomes and was tolerated reasonably well by elderly patients. Prognostic factors were identified that may help personalize future treatment.
背景/目的：老年癌症患者更为普遍，需要特别关注。本研究关注接受三联疗法治疗的老年（≥65 岁）直肠癌患者的结局。
回顾性评估了 105 名接受新辅助放化疗和局部晚期直肠癌切除术的患者。分析了 9 个特征，包括肿瘤位置、性别、年龄、体能状态、放疗技术、原发肿瘤/淋巴结分类、降期和组织学分级，以评估局部区域控制（LRC）、无转移生存（MFS）和总生存（OS）。
5 年 LRC、MFS 和 OS 率分别为 91%、78%和 87%。由于毒性，有 12 名患者（11%）未能完成放化疗；18 名患者（17%）发生 3 级毒性。共有 29 名患者（28%）发生手术并发症。多因素分析显示，MFS 与降期显著相关（p=0.003），OS 与较低的组织学分级相关（p=0.013）。
三联疗法为老年患者带来了有前景的结果，且耐受性良好。确定了预后因素，这可能有助于为未来的治疗提供个性化建议。
