Radiotherapy for cancer patients aged 80 and older: a study of effectiveness and side effects.
OBJECTIVE
To profile cancer patients aged 80 and older undergoing radiotherapy and to study the tumor response and side effects of therapy.


METHODS
We retrospectively analyzed the records of patients aged 80 and older who received radiation therapy at James A. Haley Veterans Hospital and H. Lee Moffitt Cancer Center between 1988 and 1995. A total of 203 patients aged 80-94 received radiotherapy during this period. Treatment sites included head and neck [50], breast [16], chest [37], pelvis [53], and miscellaneous [39]. Age, treatment site, field size, total dose, response to treatment, treatment interruptions, incidence and severity of weight loss, myelosuppression, diarrhea, mucositis, dermatitis, and follow-up status are assessed using our departmental records and hospital tumor registry.


RESULTS
Of 191 patients evaluated, 179 (94%) completed the treatment without serious complications. A total of 195 sites were irradiated. Twelve patients (6%) required interruption of the treatment. Therapeutic responses were seen in 86 out of 112 patients (77%) treated with curative intent (with 67% complete response) and in 67 out of 83 patients (81%) treated with palliative intent. The causes of treatment interruptions included weight loss from diarrhea, dysphagia, and progressive disease. Treatment interruptions were more likely in patients treated with large treatment fields. In patients treated for upper aero-digestive tract cancer, Grade 3 and 4 mucositis was noted in 20 and 2% of patients, respectively. Grade 1 and 2 enteritis was noted in 43% of patients treated for pelvic malignancies. Grade 3 dermatitis was noted only in 2% of patients.


CONCLUSIONS
Radiotherapy is highly effective and well tolerated by the oldest old. Age is not a contraindication to aggressive radiotherapy.
Zachariah
B
B
H. Lee Moffitt Cancer Center and Research Institute, University of South Florida College of Medicine, James A. Haley Veterans Hospital, Tampa 33612, USA.
Balducci
L
L
Venkattaramanabalaji
G V
GV
Casey
L
L
Greenberg
H M
HM
DelRegato
J A
JA
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000532:radiotherapy*; D010349:Patient Compliance; D011878:Radiotherapy / Q000009:adverse effects; D012189:Retrospective Studies