Do you offer neoadjuvant FOLFOX for elderly patients with locally advanced rectal cancer receiving short course radiation?

I would approach this case somewhat analogously to the bulk of cases of locally advanced rectal cancer by first getting an understanding of the patient's physiologic age/functional status, surgeon’s opinion on operability and concern for margins, and imaging-defined risk factors- location of tumor and influence upon type of operation, T-stage, involved MRF/CRM, mesorectal or extra-mesorectal nodes, extra-mural venous invasion, etc.

The RAPIDO regimen of short course RT followed by FOLFOX is a great TNT option for those deemed suitable (RAPIDO Trial, Bahadoer et al., 33301740).

If a patient is physiologically elderly and there is concern for neoadjuvant FOLFOX tolerance but has otherwise operable disease without high concern for risk of involv...