Abstract

Background: Pre-operative and post-operative chemoradiotherapy (CCRT) have been widely used to improve outcomes in patients with locally advanced rectal cancer. Nonetheless, pre-operative CCRT may not be tolerable in elderly patients. In contrast, post-operative CCRT with oral tegafur may have benefits including aiding in the precise selection of radiation therapy as well as being more tolerable. In the present study, we aimed to evaluate the clinical outcome of radical proctectomy followed by CCRT with oral tegafur, focusing on overall survival, progression-free survival, and toxicity among elderly patients with locally advanced rectal cancer.

Methods: From 2007 to 2018, thirty-two rectal adenocarcinoma patients aged ≥ 65 years with stage II–III who underwent radical proctectomy and had oral tegafur 300–350 mg/m² /day throughout and after an RT course that lasted for at least 6 months were included.

Result: The mean age of the patients was 71.3 ± 5.1 years, and the median follow-up time was 22.8 (2.4–113.9) months. The 9.5-year progression-free survival rate was 55.0% with a significantly better median survival time for non-progression patients (p = 0.031). The 9.5-year overall survival rate was 52.3%. None of the patients experienced hematological or gastrointestinal toxicities of exceeding grade 2. Only one patient (3.1%) experienced grade 3 radiation dermatitis.

Conclusion: Radical surgery followed by adjuvant CCRT using oral tegafur was well tolerated and resulted in fair clinical outcomes.