Clinical benefit of adding oxaliplatin to standard neoadjuvant chemoradiotherapy in locally advanced rectal cancer: a meta-analysis : Oxaliplatin in neoadjuvant treatment for rectal cancer

Background: To evaluate the treatment tolerance and clinical outcomes in patients aged 70 years and older with locally advanced oropharyngeal cancer treated by definitive intensity-modulated radiation therapy (IMRT). Patients and Methods: We retrospectively analyzed 15 consecutive elderly patients, with histologically-proven squamous cell carcinoma of the oropharynx, staged T3-4 with or without involved lymph nodes at diagnosis, who received definitive sequential IMRT (70 Gy; 2 Gy/fraction). Adult Comorbidity Evaluation-27 (ACE-27) score was calculated and its influence on treatment tolerance and clinical outcomes was analyzed. Results: A total of 15 patients were included with a median age of 77 years (range=70-88 years). At baseline, 8 patients (53.3%) had an ACE-27 score of 1, and the remainder (n=7, 46.7%) had a comorbidity index of 0. All patients completed programmed IMRT treatment, without any reduction of total dose. Oral pain and mucositis were the most common acute side-effects, classified as grade 3 in 6 patients (40%) only. Xerostomia was reported in 13 patients (86.7%), without severe manifestation.There was no hematological toxicity. ACE-27 score was not related to higher severe acute toxicity. No patients experiencedgrade 3 or more late toxicity. Five-year overall survival anddisease-free survival rates were 63.6% (95% confidenceinterval=32.7-83.3%) and 55% (95% confidenceinterval=24.4-77.6%), respectively. Comorbidity score did not influence survival outcomes, both overall survival (p=0.46)and disease-free survival (p=0.55). Conclusion: Treatment tolerance, as well as survival outcomes were good in elderlyoropharyngeal cancer patients treated with definitive sequential IMRT. Due to age and comorbidity, no dose orvolume reduction for IMRT should be considered in this setting of patients. A prospective randomized trial with a largesample size should be conducted to confirm our results