TREATMENT OUTCOME FOLLOWING RADIOTHERAPY IN ELDERLY PATIENTS WITH BLADDER-CANCER

Background and purpose: The optimal treatment of elderly patients with bladder cancer is not established. This study aimed to evaluate progn ostic variables for survival and morbidity, which may be important for treatment strategy. Material and methods: The medical records of 94, patients aged greater than or equal to 75 years receiving curatively i ntended radiotherapy for bladder cancer were reviewed retrospectively. Results: Median age was 78 years (range 75-93 years). Fifty patients had T1-2 tumors, and 42 patients had T3-4 tumors. The total planned do se was 57.6-62.6 Gy in 24-30 fractions in 6 weeks. In 76 patients, a 2 week rest period was planned after 16 fractions (split course). Half of the patients were hospitalized during or after the treatment becaus e of gastrointestinal or urogenital side effects. Median survival was 13.9 months (range 0.6-150.0 + months), 29% survived for 2 years and 7 8 survived for 5 years. Patients aged >78 years survived for a shorter period than patients aged 75-78 years (13.4 versus 16.1 months). Univ ariate survival analysis revealed that low stage (T1-2), good performa nce status (PS less than or equal to 1), split course treatment, no tr eatment interruption due to side effects, and no hospitalization durin g treatment were associated with long survival. In multivariate analys es, T-stage, split course treatment, and performance status were indep endent prognostic factors. Conclusion: The results confirm that curati ve intended radiotherapy is feasible in elderly patients, but patients with stage T3-4 and PS > 1 have a short survival. These patients shou ld be offered palliative treatment. (C) 1997 Elsevier Science Ireland Ltd.