ROLE OF RADIATION-THERAPY IN THE TREATMENT OF COLORECTAL-CANCER - IMPLICATIONS FOR THE OLDER PATIENT

Radiation therapy plays an important role in the treatment of patients with colorectal cancer. Randomized trials show that patients with rec tal cancer have an 8% improved local control rate with postoperative r adiation and an 11-13% improved local control rate with combined posto perative radiation and chemotherapy. Survival is also improved for the se patients. Ongoing randomized trials may clarify the role of postope rative radiation therapy for patients with colon cancer. Although ther e is little specific information regarding the tolerance and response of the older patient to radiation therapy, there is no reason to belie ve that cancer in the older patient is more sensitive to ionizing radi ation. Therefore, treatment decisions should be based on the available data. The older patient may be at an increased risk for radiation-rel ated small bowel damage, and the clinician should pay particular atten tion to techniques to limit the amount of small bowel in the irradiate d field.