Analysis of 57 nonagenarian cancer patients treated by radical radiotherapy: a survey of eight institutions

Background: As the human society grows more aged, it is considered importan t to elucidate factors essential in applying radical radiotherapy (RT) to t he elderly, with ages as high as 90 years and greater. Methods: A retrospective survey was conducted for patients 90 years of age or older who received radiotherapy with radical intent in eight leading ins titutions in Japan from 1990 through 1995. Results: Fifty-seven nonagenarian patients were studied. Their ages ranged up to 98 (median 91) and there was a strong female preponderance (M/F: 16/4 1). The distribution by site was as follows. head and neck, 16; skin and ad nexae, 11; uterine cervix, 7; esophagus, 6. The prevailing histopathologica l diagnosis was squamous cell carcinoma (34),followed by adenocarcinomas (8 ). The highest age at RT was 98 years [female, skin cancer, died of senilit y 2.5 years after treatment, with no evidence of disease (NED)] and the lon gest survivor is 102 years old (female, glottic cancer T2, age at RT 93, al ive NED for 8 years, uses wheel-chair). The rate of completion of treatment was 75% (43/57), if the treatment field was limited to the gross primary t umor volume only and if the cumulative dose was above 80% of the tolerable adult dose. Familial escort was necessary for most of the patients in compl eting the day-to-day RT. Conclusion: Radiotherapy is feasible with radical intent even in the elderl y, if the treatment field is limited to the gross primary tumor volume only , if the cumulative dose is above 80% of the tolerable adult dose and if fa milial support is adequate.