Cyrus Chargari1, Guillaume Moriceau2, Pierre Auberdiac3, Jean-Baptiste Guy2, Avi Assouline4, Fabien Tinquaut5, Alexander Tuan Falk6, Houda Eddekkaoui2, Aurélie Bourmaud5, Yvan Coscas4, Pierre Annede7, Romain Rivoirard2, Benoite Mery2, Jane-Chloé Trone2, Yves Otmezguine4, Cécile Pacaut2, Olivier Bauduceau7, Lionel Vedrine7, Yacine Merrouche8, Nicolas Magne2. 1. Medical and Radiation Oncology, Hôpital d'Instruction des Armées du Val-de-Grâce, Paris, France. Electronic address: chargari-vdg@hotmail.fr. 2. Radiation Oncology, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France. 3. Radiation Oncology, Clinique Claude Bernard, Albi, France; Radiation Oncology, Centre Hospitalier, Rodez, France. 4. Radiation Oncology, Centre Clinique de la Porte de Saint Cloud, Boulogne-Billancourt, France. 5. Centre Hygée - Centre Régional de Prévention des Cancers, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France. 6. Departement of Radiation Therapy, Centre Antoine Lacassagne, Nice, France. 7. Medical and Radiation Oncology, Hôpital d'Instruction des Armées du Val-de-Grâce, Paris, France. 8. Medical Oncology, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France.
Abstract
BACKGROUND: There are only scarce data on the management of patients aged 90years or older with cancer, and more particularly on the place of radiation therapy (RT). We report the first large study on patients (pts) aged 90years or older receiving RT. METHODS AND MATERIALS: Records from RT departments from five institutions were reviewed to identify pts 90years 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 93.2years (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 36Gy (4-76Gy). 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 22.9months (95CI: 15.5-42.7months). 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 90years 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.
BACKGROUND: There are only scarce data on the management of patients aged 90years or older with cancer, and more particularly on the place of radiation therapy (RT). We report the first large study on patients (pts) aged 90years or older receiving RT. METHODS AND MATERIALS: Records from RT departments from five institutions were reviewed to identify pts 90years 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 93.2years (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 36Gy (4-76Gy). 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 22.9months (95CI: 15.5-42.7months). 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 90years 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.
Authors: Benoîte Méry; Alexander T Falk; Avi Assouline; Jane-Chloé Trone; Jean-Baptiste Guy; Romain Rivoirard; Pierre Auberdiac; Julien Langrand Escure; Coralie Moncharmont; Guillaume Moriceau; Hweej Almokhles; Guy de Laroche; Cécile Pacaut; Aline Guillot; Cyrus Chargari; Nicolas Magné Journal: Int Urol Nephrol Date: 2015-05-17 Impact factor: 2.370
Authors: Romain Rivoirard; Coralie Moncharmont; Avi Assouline; Pierre Auberdiac; Benoite Mery; Alexander Tuan Falk; Pierre Annède; Jane-Chloé Trone; Jean-Baptiste Guy; Nicolas Vial; Pierre Fournel; Yacine Merrouche; Cyrus Chargari; Nicolas Magné Journal: Eur Arch Otorhinolaryngol Date: 2014-04-02 Impact factor: 2.503