title: Feasibility of radiation therapy in patients 90years of age and older: a French multicentre analysis.
abstract: BACKGROUND
  There are only scarce data on the management of patients aged 90years or older with cancer, and more particularly on the place of radiation therapy (RT). We report the first large study on patients (pts) aged 90years or older receiving RT.
  
  
  METHODS
  Records from RT departments from five institutions were reviewed to identify pts 90years of age and older who underwent RT for various malignant tumours treated between 2003 and 2012. Tumours' characteristics were examined, as well as treatment specificities and treatment intent.
  
  
  RESULTS
  308 pts receiving 318 RT courses were identified, mean age was 93.2years (standard deviation 2.8). Treatment was given with curative and palliative intent in 44% and 56%, respectively. Factors associated with a curative treatment were performance status (PS), place of life, previous surgery and tumour stage. Median total prescribed dose was 36Gy (4-76Gy). Hypofractionation and split course were used in 88% and 7.3%, respectively. Most toxicities were mild to moderate. RT could not be completed in 23 pts (7.5%). No long-term toxicity was reported. Median overall survival was 22.9months (95CI: 15.5-42.7months). Cancer was the cause of death in 8.7% and 46% of pts treated with curative and palliative intent, respectively.
  
  
  CONCLUSIONS
  This study shows that RT is feasible for patients aged 90years or more. PS, place of life and tumour stage were factors of the therapeutic decision. There is no reason to withdraw pts with good general health condition from potentially curative RT, provided that careful attention is paid to factors of toxicity and to geriatric vulnerabilities.
authors.affiliation: Medical and Radiation Oncology, Hôpital d'Instruction des Armées du Val-de-Grâce, Paris, France. Electronic address: chargari-vdg@hotmail.fr.
authors.forename: Cyrus
authors.initials: C
authors.lastname: Chargari
authors.affiliation: Radiation Oncology, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Moriceau
authors.affiliation: Radiation Oncology, Clinique Claude Bernard, Albi, France; Radiation Oncology, Centre Hospitalier, Rodez, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Auberdiac
authors.affiliation: Radiation Oncology, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Guy
authors.affiliation: Radiation Oncology, Centre Clinique de la Porte de Saint Cloud, Boulogne-Billancourt, France.
authors.forename: Avi
authors.initials: A
authors.lastname: Assouline
authors.affiliation: Centre Hygée - Centre Régional de Prévention des Cancers, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France.
authors.forename: Fabien
authors.initials: F
authors.lastname: Tinquaut
authors.affiliation: Departement of Radiation Therapy, Centre Antoine Lacassagne, Nice, France.
authors.forename: Alexander Tuan
authors.initials: AT
authors.lastname: Falk
authors.affiliation: Radiation Oncology, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France.
authors.forename: Houda
authors.initials: H
authors.lastname: Eddekkaoui
authors.affiliation: Centre Hygée - Centre Régional de Prévention des Cancers, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Bourmaud
authors.affiliation: Radiation Oncology, Centre Clinique de la Porte de Saint Cloud, Boulogne-Billancourt, France.
authors.forename: Yvan
authors.initials: Y
authors.lastname: Coscas
authors.affiliation: Medical and Radiation Oncology, Hôpital d'Instruction des Armées du Val-de-Grâce, Paris, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Annede
authors.affiliation: Radiation Oncology, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Rivoirard
authors.affiliation: Radiation Oncology, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France.
authors.forename: Benoite
authors.initials: B
authors.lastname: Mery
authors.affiliation: Radiation Oncology, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France.
authors.forename: Jane-Chloé
authors.initials: JC
authors.lastname: Trone
authors.affiliation: Radiation Oncology, Centre Clinique de la Porte de Saint Cloud, Boulogne-Billancourt, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Otmezguine
authors.affiliation: Radiation Oncology, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Pacaut
authors.affiliation: Medical and Radiation Oncology, Hôpital d'Instruction des Armées du Val-de-Grâce, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Bauduceau
authors.affiliation: Medical and Radiation Oncology, Hôpital d'Instruction des Armées du Val-de-Grâce, Paris, France.
authors.forename: Lionel
authors.initials: L
authors.lastname: Vedrine
authors.affiliation: Medical Oncology, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France.
authors.forename: Yacine
authors.initials: Y
authors.lastname: Merrouche
authors.affiliation: Radiation Oncology, Institut de Cancérologie Lucien Neuwirth, Saint Priest en Jarez, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Magne
mesh_terms: D000369:Aged, 80 and over; D019583:Dose Fractionation, Radiation; D005240:Feasibility Studies; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Cancer; Effectiveness; Elderly; Geriatrics; Radiation therapy; Toxicity