Carsten Nieder1, Kent Angelo2, Ellinor Haukland3, Adam Pawinski3. 1. Department of Oncology and Palliative Medicine, Nordland Hospital, Bodø, Norway Institute of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway carsten.nieder@nlsh.no. 2. Institute of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway. 3. Department of Oncology and Palliative Medicine, Nordland Hospital, Bodø, Norway.
Abstract
BACKGROUND/AIM: Older cancer patients might experience inferior survival outcomes. However, no standard age cut-off is currently being used for commonly administered treatments such as radiotherapy. We evaluated survival outcomes and prognostic factors for survival after palliative radiotherapy (PRT) in our oldest patients (age≥80 years). PATIENTS AND METHODS: This retrospective study covered the time period between 2007 and 2012, and included 94 patients in this age group who were treated with PRT. Comparisons to a group of younger patients (31-79 years of age, N=445) treated during the same time period were made. Uni- and multivariate analyses were also performed. Most patients received PRT for bone and brain metastases or in order to improve thoracic symptoms from lung cancer. RESULTS: Median age was 83 years. Survival outcomes and rates of PRT completion were not significantly different. Short median survival of less than 2 months was observed in two sub-groups of geriatric patients; those with brain metastases and those with Eastern Cooperative Oncology Group (ECOG) performance status (PS) 4. Multivariate analysis confirmed the prognostic impact of PS, adrenal gland metastases, progressive disease outside PRT target volume(s), need for opioid analgetics and steroids (all p<0.05). Brain metastasis was associated with a borderline increase in risk of mortality (p=0.051). CONCLUSION: Our data support utilization of PRT irrespective of age for most patients with PS 0-3 but care should be taken in selecting the right fractionation regimen in order to avoid lengthy PRT courses when survival is limited. Copyright
BACKGROUND/AIM: Older cancerpatients might experience inferior survival outcomes. However, no standard age cut-off is currently being used for commonly administered treatments such as radiotherapy. We evaluated survival outcomes and prognostic factors for survival after palliative radiotherapy (PRT) in our oldest patients (age≥80 years). PATIENTS AND METHODS: This retrospective study covered the time period between 2007 and 2012, and included 94 patients in this age group who were treated with PRT. Comparisons to a group of younger patients (31-79 years of age, N=445) treated during the same time period were made. Uni- and multivariate analyses were also performed. Most patients received PRT for bone and brain metastases or in order to improve thoracic symptoms from lung cancer. RESULTS: Median age was 83 years. Survival outcomes and rates of PRT completion were not significantly different. Short median survival of less than 2 months was observed in two sub-groups of geriatric patients; those with brain metastases and those with Eastern Cooperative Oncology Group (ECOG) performance status (PS) 4. Multivariate analysis confirmed the prognostic impact of PS, adrenal gland metastases, progressive disease outside PRT target volume(s), need for opioid analgetics and steroids (all p<0.05). Brain metastasis was associated with a borderline increase in risk of mortality (p=0.051). CONCLUSION: Our data support utilization of PRT irrespective of age for most patients with PS 0-3 but care should be taken in selecting the right fractionation regimen in order to avoid lengthy PRT courses when survival is limited. Copyright
Authors: Tilman Bostel; Robert Förster; Ingmar Schlampp; Tanja Sprave; Sati Akbaba; Daniel Wollschläger; Jürgen Debus; Arnulf Mayer; Heinz Schmidberger; Harald Rief; Nils Henrik Nicolay Journal: Strahlenther Onkol Date: 2019-06-25 Impact factor: 3.621