Radiotherapy among nonagenarians with anal or rectal carcinoma:should we avoid or adapt treatment?

Dear editor, Radiotherapy is a cornerstone in the management of anal or rectal cancer. Because elderly patients are often excluded from clinical trials, little is known about radi-otherapy's therapeutic index (efficacy/toxicity ratio) in the geriatric population 1]. Still, the ageing of popula-tion imposes the challenge to treat older cancer patients and probably to adjust their treatment 2]. A few studies reported data on radiation-induced toxicities in nonage-narian patients, but data on efficacy are still scarce.