Preoperative chemoradiotherapy in older patients with rectal cancer guided by comprehensive geriatric assessment within a multidisciplinary team—a multicenter phase II trial

作者：Wenyang Liu, Yuan Tang, Ning Li, Yu Tang, Yunjie Cheng, Lin Yang, Hui Fang, Ning-Ning Lu, Shunan Qi, B. Chen, Shulian Wang, Yong-Wen Song, Yueping Liu, Ye‐Xiong Li, Zheng Liu, Jian-Wei Liang, Wei Pei, Xishan Wang, Haizeng Zhang, Jun Wang, Hai-Tao Zhou, Jing Jin · 发表于：BMC Geriatrics · 年份：2024 · DOI：10.1186/s12877-024-05046-6 · 被引用次数：5 · 研究领域：Frailty in Older Adults、Colorectal Cancer Surgical Treatments、Stoma care and complications

BACKGROUND: The purpose of this study was to evaluate the safety and efficacy of preoperative concurrent chemoradiotherapy (preCRT) for locally advanced rectal cancer in older people who were classified as "fit" by comprehensive geriatric assessment (CGA). METHODS: A single-arm, multicenter, phase II trial was designed. Patients were eligible for this study if they were aged 70 years or above and met the standards of "fit" (SIOG1) as evaluated by CGA and of the locally advanced risk category. The primary endpoint was 2-year disease-free survival (DFS). Patients were scheduled to receive preCRT (50 Gy) with raltitrexed (3 mg/m2 on days 1 and 22). RESULTS: One hundred and nine patients were evaluated by CGA, of whom eighty-six, eleven and twelve were classified into the fit, intermediate and frail category. Sixty-eight fit patients with a median age of 74 years were enrolled. Sixty-four patients (94.1%) finished radiotherapy without dose reduction. Fifty-four (79.3%) patients finished the prescribed raltitrexed therapy as planned. Serious toxicity (grade 3 or above) was observed in twenty-four patients (35.3%), and fourteen patients (20.6%) experienced non-hematological side effects. Within a median follow-up time of 36.0 months (range: 5.9-63.1 months), the 2-year overall survival (OS), cancer-specific survival (CSS) and disease-free survival (DFS) rates were 89.6% (95% CI: 82.3-96.9), 92.4% (95% CI: 85.9-98.9) and 75.6% (95% CI: 65.2-86.0), respectively. Forty-eight patients ...