Radiotherapy in the management of cervical cancer in elderly patients

Purpose: To report treatment results and complications experienced by elder ly patients treated with curatively intended radiotherapy for cancer of the uterine cervix. Patients and methods: One hundred and fourteen elderly patients (median 75. 5 years, range 70.0-85.9) consecutively referred for curative radiotherapy in the period 1987-1996 were prospectively followed with regard to tumour c ontrol and complications. The importance of age, stage (FIGO), tumour size, histology, tumour fixation, haemoglobin, concurrent disease, performance s tatus (WHO) and type of radiotherapy were assessed using univariate and mul tivariate analyses. Results: Treatment was completed as planned in 68%, delayed in 29% and stop ped prematurely in 3%;. The frequency of grade 3 late complications was 11% and the actuarial probability at 5 years was 20%. Overall 5-year survival according to FIGO was 61% (I), 34% (II) and 25% (III). Cox multivariate ana lysis identified tumour size as independent prognostic factor for tumour co ntrol, disease-free survival and overall survival. FIGO stage was predictiv e for late grade 2 complications. We were unable to identify significant fa ctors with respect to grade 3 complications. Age was not a significant para meter for any of the investigated endpoints. Conclusion: Elderly patients in good performance status with advanced cance r of the uterine may tolerate radical radiotherapy with acceptable morbidit y and reasonable survival. Radiotherapy may also be a good alternative in e arly stage disease for surgically unfit elderly patients. (C) 2000 Elsevier Science ireland Ltd. All rights reserved.