Radiation therapy of the older patient

Radiotherapy is widely used for both curative and palliative treatment of c ancer. It is of particular benefit to older and frail patients as an altern ative to surgery and systemic therapy Very little information is available regarding the tolerance and effectiveness of radiotherapy in older patients . Review of the literature shows that selected patients who have good perfo rmance status and fewer comorbid illnesses tolerate radiotherapy as well as younger patients. Older patients with early stage cancer should be treated aggressively including treatment with combined chemoradiation, if indicate d. Innovative methods of treatment delivery, namely brachytherapy, sterotac tic radiosurgery, hyperfractionated radiotherapy three-dimensional conforma l radiotherapy and others, were tried successfully in selected older patien ts with no added morbidity. Older patients with good performance status aft er comprehensive geriatric assessment should be considered for prospective studies. Aggressive treatment should not be denied to older patients based on age alone.