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Elderly patients diagnosed with rectal cancer may benefit from combined treatment with chemotherapy and radiation. These results were recently published in the journal Cancer.

The rectum is part of the digestive system. It makes up the final six inches of the large intestine. Cancer of the colon or rectum is often referred to as colorectal cancer. Colorectal cancer is the fourth-most common cancer among men and women in the United States. Fortunately, when detected early it is often curable.

Current treatments for rectal cancer include surgery, chemotherapy, and radiation. Factors that influence choice of treatment include risk of recurrence, extent of spread, and the patient’s general health. At the time of diagnosis, the physician determines the stage of the cancer. Staging involves determining if the cancer has spread, and how far, and if the surrounding lymph nodes are affected. Treatment and prognosis for colorectal cancer often depends on the stage, with earlier stages often requiring less aggressive treatment than advanced stages.

Some elderly colorectal cancer patients cannot tolerate standard treatment approaches due to compromised overall health or other existing medical conditions.

Researchers in this study evaluated 2,886 patients who were diagnosed with either Stage II or III rectal cancer. Stage II rectal cancer has not spread to the surrounding lymph nodes. Stage III rectal cancer has spread to one or more lymph nodes. All patients underwent surgery to remove as much of the cancer as possible before receiving other treatment. The researches then compared the treatment regimens given to the Stage II group with those give to the Stage III group.

  • 45% of all the patients received both chemotherapy and radiation.
  • Stage III patients were more likely to receive chemotherapy and radiation than the Stage II group.
  • The researchers also noted that between the years of 1992 and 1999, the number of Stage II patients who received chemotherapy and radiation increased significantly, although no reason was noted.
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Results regarding completion of therapy are as follows:

  • Stage III patients were more likely to complete radiation than chemotherapy (96% versus 68%).
  • 67% of patients completed both treatment regimens.
  • Stage II patients were less likely overall to complete their treatment regimens, with 91% completing radiation, 49% completing chemotherapy, and only 47% completing both chemotherapy and radiation.
  • Further analysis revealed that only a complete course of chemotherapy and radiation for both Stage II and III improved the five-year recurrence risk when compared with patients who received no treatment following surgery.

The researchers concluded that even though elderly Stage II rectal cancer patients were less likely to receive and complete chemotherapy and radiation, both Stage II and Stage III groups had a lower risk of cancer-related deaths when they completed both treatment regimens.

Reference: Dobie, S., Warren, J., Matthews, B. Survival benefits and trends in use of adjuvant therapy among early stage ii and iii rectal cancer patients in the general population. Cancer. 2008. 112(4). 789-799.

Related News:Delay in Chemotherapy Associated with Worse Outcomes for Elderly with Colorectal Cancer(11/27/2006)

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