Palliative pelvic radiotherapy for symptomatic frail or metastatic patients with rectal adenocarcinoma: A systematic review.

Background: Locally advanced rectal cancer can cause severe symptomatic pelvic morbidity such as pain, haemorrhage or bowel obstruction for frail or metastatic patients, which are often unfit to undergo surgery or intense systemic treatment. The most frequent radiation schedule is 25 Gy/ 5f but the optimal dose is yet to determine. Our aim was to conduct a systematic review on the efficacy and toxicity of the published radiation schedules of palliative rectal cancer.

[Place of radiotherapy in the treatment of rectal cancer in the elderly].

Rectal cancer is a common disease of the elderly. Current treatment recommendations are established for young subjects in good general health condition, without taking into account the frailty, comorbidities and polymedications inherent in patients over 75 years old. For locally advanced lower and middle rectal cancers (T3, T4 or N+), these are based on variations of regimens including neoadjuvant chemoradiotherapy, surgery of the rectum with total removal of the mesorectum, and a possibility of adjuvant chemotherapy.