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Stereotactic Radiosurgery for Gynecologic Cancer
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Short-Course Radiotherapy in Locally Advanced Rectal Cancer.

Maria Cambray1, Javier Gonzalez-Viguera1, Miguel Angel Berenguer1

  • 1Catalan Institute of Oncology, Radiation Oncology Department, L'Hospitalet de Llobregat, Barcelona, Spain.

Clinical and Translational Gastroenterology
|June 23, 2020
PubMed
Summary
This summary is machine-generated.

Short-course preoperative radiotherapy (RT) is effective for elderly rectal cancer patients with comorbidities. This treatment offers survival rates comparable to the general population with acceptable toxicity, making it a suitable option.

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Surgical Oncology

Background:

  • Optimal treatment for locally advanced rectal cancer in elderly patients or those with comorbidities remains unclear.
  • Standard neoadjuvant chemoradiotherapy may pose significant toxicity risks for frail patient populations.

Purpose of the Study:

  • To evaluate the efficacy and safety of a neoadjuvant short-course preoperative radiotherapy (RT) protocol in elderly patients and/or those with comorbidities with locally advanced rectal cancer.

Main Methods:

  • A prospective treatment protocol was established in 2009, including short-course preoperative RT followed by standard surgery +/- chemotherapy.
  • The study included 87 frail patients, primarily over 80 years old or with comorbidities.
  • Follow-up averaged 43.5 months.

Main Results:

  • At 36 months, disease-specific survival was 86.3% and disease-free survival was 82.8%; at 60 months, these were 78.2% and 78%, respectively.
  • Local recurrence rate was 2.5%, with an R0 resection rate of 95%.
  • Late radiotoxicity occurred in 9% of patients, and surgical complications were manageable.

Conclusions:

  • Neoadjuvant short-course preoperative RT in elderly patients and/or those with comorbidities yields therapeutic outcomes comparable to the general population treated with neoadjuvant chemoradiotherapy.
  • This treatment scheme demonstrates acceptable toxicity and is considered the most appropriate therapeutic option for this specific patient group.