Abstract
Background
There are only scarce data on the management of patients aged 90 years or older with cancer, and more particularly on the place of radiation therapy
(RT). We report the first large study on patients (pts) aged 90 years or older receiving RT.
Methods and materials
Records from RT departments from five institutions were reviewed to identify pts 90 years of age and older who underwent RT for various malignant tumours treated between
2003 and 2012. Tumours’ characteristics were examined, as well as treatment specificities
and treatment intent.
Results
308 pts receiving 318 RT courses were identified, mean age was 93.2 years (standard deviation 2.8). Treatment was given with curative and palliative intent
in 44% and 56%, respectively. Factors associated with a curative treatment were performance
status (PS), place of life, previous surgery and tumour stage. Median total prescribed
dose was 36 Gy (4–76 Gy). Hypofractionation and split course were used in 88% and 7.3%, respectively. Most
toxicities were mild to moderate. RT could not be completed in 23 pts (7.5%). No long-term
toxicity was reported. Median overall survival was 22.9 months (95CI: 15.5–42.7 months). Cancer was the cause of death in 8.7% and 46% of pts treated with curative
and palliative intent, respectively.
Conclusion
This study shows that RT is feasible for patients aged 90 years or more. PS, place of life and tumour stage were factors of the therapeutic
decision. There is no reason to withdraw pts with good general health condition from
potentially curative RT, provided that careful attention is paid to factors of toxicity
and to geriatric vulnerabilities.
Keywords
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Article info
Publication history
Published online: March 12, 2014
Identification
Copyright
© 2014 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
