Owing to the gradual aging of today’s population, an increase in the prevalence of frailty syndrome has been noticed. This complex state of health, characterized by decreased resilience and tolerance with concurrent increased vulnerability to stressors and adverse health-related factors, has drawn researchers’ attention in recent years. Rectal cancer, which constitutes ~30% of all colorectal cancers, is a disease noticeably related to the elderly. In its locally advanced form, it is conventionally treated with trimodal therapy—neoadjuvant chemoradiotherapy followed by total mesorectal excision and adjuvant chemotherapy. Despite its good clinical outcomes and improvement in rectal cancer local control, as evidenced by clinical trials, it remains unclear if all frail patients benefit from that approach since it may be associated with adverse side effects that cannot be handled by them. As old patients, and frail ones even more noticeably, are poorly represented in the clinical trials describing outcomes of the standard treatment, this article aims to review the current knowledge on the trimodal therapy of rectal cancer with an emphasis on novel approaches to rectal cancer that can be implemented for frail patients.
由于当今人口逐渐老龄化，虚弱综合征的患病率有所增加。这种复杂的健康状况以恢复力和耐受性下降为特征，同时对应激源和不良健康相关因素的易感性增加，近年来引起了研究人员的关注。直肠癌约占所有结直肠癌的30%，是一种与老年人明显相关的疾病。对于局部晚期直肠癌，常规采用三模式疗法——即新辅助放化疗后进行全直肠系膜切除术及辅助化疗。尽管临床试验证明该疗法具有良好的临床效果并改善了直肠癌的局部控制，但由于可能伴随患者无法承受的不良副作用，目前尚不清楚所有虚弱患者是否能从该疗法中获益。由于描述标准治疗结果的临床试验中老年患者（尤其是虚弱患者）的代表性严重不足，本文旨在综述当前关于直肠癌三模式疗法的研究进展，重点关注可适用于虚弱患者的直肠癌新型治疗方案。
The Role of Frailty in the Treatment of Locally Advanced Rectal Cancer
肿瘤(癌症)患者之家