Selina Chow1, Keyue Ding2, Bo Angela Wan1, Michael Brundage3, Ralph M Meyer4, Abdenour Nabid5, Pierre Chabot6, Genevieve Coulombe7, Shahida Ahmed8, Joda Kuk9, A Rashid Dar10, Aamer Mahmud11, Alysa Fairchild12, Carolyn F Wilson2, Jackson S Y Wu13, Kristopher Dennis14, Carlo DeAngelis1, Rebecca K S Wong15, Liting Zhu2, Edward Chow1. 1. 1 Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada. 2. 2 Canadian Cancer Trials Group, Cancer Research Institute, Queen's University, Kingston, Ontario, Canada. 3. 3 Department of Radiation Oncology, Queen's University, Kingston, Ontario, Canada. 4. 4 Juravinski Hospital and Cancer Centre and McMaster University, Hamilton, Ontario, Canada. 5. 5 Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada. 6. 6 Hopital Maisonneuve-Rosemont, Montreal, Québec, Canada. 7. 7 CHUM-Hopital Notre-Dame, Montreal, Québec, Canada. 8. 8 CancerCare Manitoba, Winnipeg, Manitoba, Canada. 9. 9 Grand River Regional Cancer Centre, Grand River Hospital, Kitchener, Ontario, Canada. 10. 10 London Regional Cancer Program, London, Ontario, Canada. 11. 11 Cancer Centre of Southeastern Ontario, Kingston General Hospital, Kingston, Ontario, Canada. 12. 12 Cross Cancer Institute, Edmonton, Alberta, Canada. 13. 13 Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta, Canada. 14. 14 The Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada. 15. 15 Princess Margaret Cancer Centre, Radiation Medicine Program, Ontario Cancer Institute, University of Toronto, Toronto, Ontario, Canada.
Abstract
PURPOSE: To explore the age difference in response and patient-reported outcomes in patients with cancer having bone metastases undergoing palliative radiotherapy. METHODS: Patients completed the European Organisation for Research and Treatment of Cancer (EORTC) Quality-of-Life (QOL) Bone Metastases module (QLQ-BM22), EORTC QOL Core-15-Palliative (QLQ-C15-PAL), and Dexamethasone Symptom Questionnaire (DSQ) before a single 8-Gy radiation treatment, on days 10 and 42 after treatment. Patient demographics, performance status, analgesic consumption, BM22, C15, and DSQ were compared with multivariant analysis between patients under 75 years and 75 years and older. Multiple linear regression models were used to assess the differences between age-groups, adjusting for baseline demographics and primary disease sites. RESULTS: There were 298 patients (170 male) with 209 (70%) less than 75 years of age. Most common primary cancer sites include lung, prostate, and breast. At baseline, younger patients had better performance status, consumed more analgesic, and reported worse scores in nausea, insomnia, and functional interference, while older patients more commonly had prostate cancer. There were no significant differences in the incidence of radiation-induced pain flare; response to radiation; changes from baseline for BM22, C15-PAL; and DSQ, nor overall survival at day 42 between the 2 groups. Responders to radiation in the elderly group reported better improvement in physical and emotional domains when compared with nonresponders. CONCLUSIONS: In patients with cancer having bone metastases undergoing palliative radiotherapy, there was no significant difference in general with age in response to radiation and patient-reported outcomes. Palliative radiotherapy should be offered to elderly patients when needed.
RCT Entities:
PURPOSE: To explore the age difference in response and patient-reported outcomes in patients with cancer having bone metastases undergoing palliative radiotherapy. METHODS:Patients completed the European Organisation for Research and Treatment of Cancer (EORTC) Quality-of-Life (QOL) Bone Metastases module (QLQ-BM22), EORTC QOL Core-15-Palliative (QLQ-C15-PAL), and Dexamethasone Symptom Questionnaire (DSQ) before a single 8-Gy radiation treatment, on days 10 and 42 after treatment. Patient demographics, performance status, analgesic consumption, BM22, C15, and DSQ were compared with multivariant analysis between patients under 75 years and 75 years and older. Multiple linear regression models were used to assess the differences between age-groups, adjusting for baseline demographics and primary disease sites. RESULTS: There were 298 patients (170 male) with 209 (70%) less than 75 years of age. Most common primary cancer sites include lung, prostate, and breast. At baseline, younger patients had better performance status, consumed more analgesic, and reported worse scores in nausea, insomnia, and functional interference, while older patients more commonly had prostate cancer. There were no significant differences in the incidence of radiation-induced pain flare; response to radiation; changes from baseline for BM22, C15-PAL; and DSQ, nor overall survival at day 42 between the 2 groups. Responders to radiation in the elderly group reported better improvement in physical and emotional domains when compared with nonresponders. CONCLUSIONS: In patients with cancer having bone metastases undergoing palliative radiotherapy, there was no significant difference in general with age in response to radiation and patient-reported outcomes. Palliative radiotherapy should be offered to elderly patients when needed.
Entities:
Keywords:
age; bone metastases; elderly; pain Introduction; palliative radiation treatment; quality of life
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
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