Localized prostate cancer in elderly patients. Outcome after radiation therapy compared to matched younger patients.
OBJECTIVE
To detect a difference in outcome (disease-specific survival, local tumor progression, late toxicity, quality of life) after curative radiotherapy for localized prostate cancer in elderly as compared to younger patients.


METHODS
In a retrospective analysis 59 elderly patients (> 74 years old) were matched 1:2 with younger patients from the data base according to tumor stage, grading, pre-treatment PSA values and year of radiotherapy. Surviving patients were contacted to fill in a validated questionnaire for quality of life measurement (EORTC QLQ-C30). Median follow-up for elderly and younger patients was 5.2 and 4.5 years, respectively.


RESULTS
Overall survival at 5 years was 66% for the elderly and 80% for younger patients. Intercurrent deaths were observed more frequently in the elderly population. There was no age-specific difference in disease-specific survival (78% vs 82%), late toxicity or quality of life. Clinically meaningful local tumor progression was observed in 15% and 14%, respectively, corresponding to data from the literature following hormonal ablation.


CONCLUSIONS
There is no obvious difference in outcome including disease-specific survival, late toxicity and quality of life in elderly patients, compared to a matched younger population. A clinically meaningful local tumor progression following radiotherapy or hormonal ablation only is rare. Local radiotherapy or, alternatively, hormonal ablation is recommended to preserve local progression-free survival in elderly patients except for very early stage of disease (i.e. T1 G1-2 M0).
Huguenin
P U
PU
Radiation Oncology Department, University Hospital Zurich, Switzerland. Pia.Huguenin@dmr.usz.ch
Bitterli
M
M
Lütolf
U M
UM
Bernhard
J
J
Glanzmann
C
C
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000401:mortality / Q000532:radiotherapy*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000532:radiotherapy*; D011788:Quality of Life; D011878:Radiotherapy / Q000009:adverse effects; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome