M. Oguchi et al., EXPERIENCES OF 23 PATIENTS GREATER-THAN-OR-EQUAL-TO-90 YEARS OF AGE TREATED WITH RADIATION-THERAPY, International journal of radiation oncology, biology, physics, 41(2), 1998, pp. 407-413
Citations number
21
Categorie Soggetti
Oncology,"Radiology,Nuclear Medicine & Medical Imaging
Purpose: To present 23 patients greater than or equal to 90 years old
treated with radiotherapy, and to retrospectively evaluate the results
of radiotherapy and tolerance in these patients. Methods and Material
s: The clinical records of 27 patients over 90 Sears of age who were t
reated with radiotherapy at the Department of Radiology, Shinshu Unive
rsity Hospital, and eight affiliated general hospitals from 1990 until
1995 were reviewed. The strategy of radiotherapy, was individually pl
anned depending on the stage of the disease and performance status (PS
) of the patient; however, it was not modified, based solely on chrono
logic age. The overall survival rate and disease-free survival rate me
re determined using the Kaplan-Meier method. The Radiation Therapy Onc
ology Group scoring criteria of acute and late reactions of radiation
therapy were used. Results: This group of patients accounted for 0.37%
of all patients treated with radiotherapy in these hospitals. Of thes
e, 23 patients in whom cancer was pathologically confirmed and whose f
ollow-up data were available for retrospective analysis were included
in the final evaluation of data. The age of the 23 patients ranged fro
m 90 to 96 years (median 93). Tumor was untreated and in the early sta
ge in five patients, locoregionally advanced in 13, recurrent in four,
and systemic: in one. Definitive radiation therapy was administered i
n 12 patients (13 sites), preoperative intent in one, anti palliative
intent in 10. The period of observation ranged from 2.5 to 6 years (me
dian 18 months). Seven patients were alive for 15-67 months. Fourteen
patients died because of intercurrent diseases or senility associated
with active cancer, and two because of senility without evidence of ca
ncer. The overall and relapse-free survival rates were 65% and 30% at
1 year and 30% and 21% at 2 gears, respectively. Definitive radiation
therapy was completed in 13 of 13 patients (100%), and local control w
as attained in 9 of 13 patients at 6 months (62%). Palliative radiatio
n therapy was completed as intended in 7 of 11 (64%), and effects of p
alliation mere observed in 9 of 11 patients (81%). Acute dermatitis, m
ucositis, pharyngitis, esophagitis, and cystitis of grade 23 related t
o the definitive radiation therapy were tolerable for the patients wit
h good PS. It took 3-7 weeks (median 5) for acute moist desquamation o
f six lesions of skin cancer to heal. Depending on the radiation doses
, grade 1-2 atrophy of skin and telangiectasia were documented for eig
ht patients followed up for more than 1 year. A brief description of r
epresentative case is presented. Conclusion: Patients older than 90 Se
ars with good PS may tolerate the acute effects of radiotherapy admini
stered according to conventional fractionation schedules. Definitive r
adiation therapy should be considered, when applicable, even for patie
nts older than 90 years. (C) 1998 Elsevier Science Inc.