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Session: ePoster: Rectal Cancer 1 (Sun8)

EP373 - Efficacy of Neoadjuvant Hypofractionated Chemoradiotherapy in Elderly Patients with Locally Advanced Rectal Cancer: A Single-center Retrospective Analysis

Sunday, May 11, 2025
8:38 AM – 8:43 AM PT
Location: Monitor 10, Sails Pavilion, Upper Level

    ePoster Presenter(s)

  • Jae Seung Kim, MD

    Resident
    Chonnam National University Hwasun Hospital
    Gwangju, Kwangju-jikhalsi, Republic of Korea

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • HP

    Hyeung-min Park, MD

    Assistant Professor
    Chonnam National University Hwasun Hospital
    Hwasun, Cholla-namdo, Republic of Korea

    Disclosure information not submitted.

    • Senior Author(s)

  • Soo Young Lee, MD, PhD

    Associate Professor
    Chonnam National University Hwasun Hospital
    Hwasun, Cholla-namdo, Republic of Korea

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • Chang Hyun Kim

    Professor
    Chonnam National University Hwasun Hospital and Medical School
    Hwasun, Cholla-namdo, Republic of Korea

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • HK

    Hyeong Rok Kim, MD, PhD

    Professor
    Chonnam National University Hwasun Hospital
    Hwasun, Cholla-namdo, Republic of Korea

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
Jae Seung Kim, MD: This individual has no financial relationships with ineligible companies.
Soo Young Lee, MD, PhD: This individual has no financial relationships with ineligible companies.
Chang Hyun Kim: This individual has no financial relationships with ineligible companies.
Hyeong Rok Kim, MD, PhD: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: The application of long-course chemoradiotherapy (LCRT) in elderly patients with locally advanced rectal cancer (LARC) can be challenging due to increased risks of complications associated with comorbidities and reduced functional status. This study aimed to assess the efficacy of neoadjuvant hypofractionated chemoradiotherapy (HCRT) in elderly patients with locally advanced mid-to-low rectal cancer.

Methods/Interventions: We performed a retrospective review of patients diagnosed with LARC from January 2013 to December 2020, and included those with age of 70 or older. Patients were categorized into three groups based on their treatment strategies: neoadjuvant HCRT (33 or 35 Gy in 10 fractions), neoadjuvant LCRT, and upfront surgery. Comparative analyses were performed on clinicopathological characteristics, short-term outcomes, and long-term survival outcomes among these groups.

Results/Outcomes: Among 296 patients included, 30 (10.1%) received HCRT, while 195 (65.9%) underwent standard LCRT and 71 (24.0%) underwent upfront surgery. Baseline characteristics showed that HCRT group had higher American Society of Anesthesiologists (ASA) score (ASA score 3 or 4, HCRT 43.3% vs. LCRT 16.9% vs. upfront surgery 15.5%; p = 0.002). HCRT group showed significantly lower incidence of radiotherapy-related complications compared to LCRT (16.7% vs. 48.7%, p = 0.001). However, the rate of pathological complete response was significantly lower in HCRT group (10.0% vs. 15.4%, p = 0.002). Three-year disease-free survival (83.0% vs. 77.2% vs. 83.2%; p = 0.411), 3-year local recurrence-free survival (93.1% vs. 93.2% vs. 93.5%; p = 0.464), and 5-year overall survival (65.1% vs. 67.0% vs. 67.7%; p = 0.682) showed no significant difference among the three groups. Multivariate analysis also showed that the treatment strategy was not associated with survival outcomes.

Conclusion/Discussion: Neoadjuvant HCRT demonstrated reduced radiotherapy-related complications and acceptable long-term oncologic outcomes. Therefore, neoadjuvant HCRT may be considered as a viable alternative for elderly patients with LARC.