Toxicities and outcomes of neoadjuvant treatment in elderly patients with locally advanced rectal cancer: a scoping review protocol

Introduction Colorectal cancer remains the second  leading cause of cancer-related death in 60–79 years  old and the third leading cause of death in patients aged  80 and above. Rectal cancer accounts for approximately  a third of colorectal cancer diagnoses. The current  standard of care for managing locally advanced rectal  cancer involves a multimodal combined approach with  neoadjuvant treatment, surgery with total mesorectal  excision and adjuvant chemotherapy. Neoadjuvant  treatment can be in the form of short-course radiotherapy,  long-course concurrent radiotherapy with chemotherapy  or total neoadjuvant chemotherapy with concurrent  chemoradiotherapy followed by chemotherapy. This  scoping aims to assess the toxicity and outcome of the  different neoadjuvant treatment modalities in elderly  patients. Methods and analysis We will use Arksey and  O'Malley’s five scoping review methodology framework  stages. Searches will be conducted in Ovid Medline,  Embase, Cochrane database and CINAHL. In addition,  the researcher will hand search for all registered trials,  using a combination of terms such as “locally advanced  rectal cancer”, “neoadjuvant treatment”, and “elderly  patients.” Two independent reviewers will screen titles and  abstracts and then full text based on predefined inclusion  and exclusion criteria. Publications will be extracted  using a customised data extraction tool to include study  characteristics, research topics, exposures and outcomes. Ethics and dissemination Ethics approval is not required  as the data will be collected from the existing literature.  The findings of this study will help with future clinical  research on the topic. We will publish the findings of this  review in a peer-reviewed journal and present them at  academic conferences targeting geriatric oncology service  providers </p