With the aging of the population,the number of older patients with rectal cancer is gradually increasing,but clinical trials often do not include older patients,leading to a lack of high-quality evidence for them.Older patients have problems such as organ function decline and underlying comorbidities,which limit their ability to receive standard tumor treatment.Comorbidity assessment scales score can be used to predict prognosis.Comprehensive geriatric assessment can be used to assist in selecting appropriate treatment regimens and screen out older patients who are more suitable for intensified treatment.The advancement of precision radiotherapy techniques has improved the tolerance of older patients to radiotherapy,which is beneficial to ensure tumor control while improving the quality of life.For older patients with rectal cancer,neoadjuvant radiotherapy combined with surgery is a feasible treatment strategy,and the tolerance of some selected older patients is comparable to that of younger patients.For older patients who achieve clinical complete remission after neoadjuvant treatment,the wait-and-see strategy is a safe and feasible alternative.For older patients who cannot tolerate surgery or have symptomatic advanced disease,palliative radiotherapy can effectively relieve symptoms and delay tumor progression.
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