Single-center retrospective study of neoadjuvant hypofractionated chemoradiotherapy for locally advanced rectal cancer in elderly patients

Application of long-course chemoradiotherapy (LCRT) in elderly patients with locally advanced rectal cancer (LARC) can be challenging due to increased risks of complication associated with comorbidities and reduced functional status. A retrospective study at Chonnam National University (Hwasun, South Korea) compared outcomes of neoadjuvant LCRT versus neoadjuvant hypofractionated chemoradiotherapy (HCRT) versus upfront surgery in LARC patients aged 70 years or older. The HCRT group showed a significantly lower incidence of radiotherapy-related complications than the LCRT group (16.7% versus 48.7%; p=0.001) but also a lower rated of pathological complete response (10.0% versus 15.4%; p=0.002). There were no significant differences between the groups for 3-year relapse-free survival, 3-year local recurrence-free survival, or 5-year overall survival. The authors conclude that neoadjuvant HCRT may be considered as a viable option for elderly patients with LARC.