title: Effect of age on response to palliative radiotherapy and quality of life in patients with painful bone metastases.
abstract: BACKGROUND
  Multimorbidity and declining performance in elderly cancer patients may result in less treatment benefit. We investigated whether age is a predictor for pain response and quality of life (QoL) after radiotherapy in patients with painful bone metastases.
  
  
  METHODS
  The database of the Dutch Bone Metastasis Study was used (1996-1999). 1157 patients, irradiated for painful bone metastases, rated their pain, QoL-domains and overall health at baseline and during follow-up. Response was calculated taking into account changes in pain score and medication. Patients were grouped into three age cohorts: A: <65 (n=520), B: 65-74 (n=410) and C: ⩾75years (n=227).
  
  
  RESULTS
  No significant difference existed in pain response between cohorts: 78% in cohort A, 74% in B and 67% in C. When assessing baseline QoL, a significant difference in activity level was noticed, with more impairment in elderly compared to younger patients (C versus B (p=0.01), C versus A (p<0.001)). Other QoL-domains were similar at baseline and during follow-up among cohorts. A pain response was significantly associated with improvement of health-related QoL (OR 3.74, 95% CI 2.66-5.25).
  
  
  CONCLUSIONS
  The majority of elderly patients with painful bone metastases responded to radiotherapy and showed comparable overall QoL compared to their younger counterparts. Age is not a predictor for pain response or QoL.
authors.affiliation: Dept. of Radiotherapy, University Medical Center Utrecht, The Netherlands. Electronic address: p.g.westhoff@umcutrecht.nl.
authors.forename: Paulien G
authors.initials: PG
authors.lastname: Westhoff
authors.affiliation: Dept. of Medical Oncology, University Medical Center Utrecht, The Netherlands.
authors.forename: Alexander
authors.initials: A
authors.lastname: de Graeff
authors.affiliation: Dept. of Medical Oncology, University Medical Center Groningen, The Netherlands.
authors.forename: Anna K L
authors.initials: AK
authors.lastname: Reyners
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands.
authors.forename: Evelyn M
authors.initials: EM
authors.lastname: Monninkhof
authors.affiliation: Dept. of Radiotherapy, University Medical Center Utrecht, The Netherlands.
authors.forename: Carla C
authors.initials: CC
authors.lastname: Rodenhuis
authors.affiliation: Dept. of Radiotherapy, University Medical Center Utrecht, The Netherlands.
authors.forename: Marco
authors.initials: M
authors.lastname: van Vulpen
authors.affiliation: Dept. of Radiotherapy, University Medical Center Nijmegen, The Netherlands.
authors.forename: Jan Willem H
authors.initials: JW
authors.lastname: Leer
authors.affiliation: Dept. of Clinical Oncology, Leiden University Medical Center, The Netherlands.
authors.forename: Corrie A M
authors.initials: CA
authors.lastname: Marijnen
authors.affiliation: Dept. of Clinical Oncology, Leiden University Medical Center, The Netherlands.
authors.forename: Yvette M
authors.initials: YM
authors.lastname: van der Linden
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001859:Bone Neoplasms / Q000523:psychology / Q000532:radiotherapy* / Q000556:secondary*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000532:radiotherapy*; D010147:Pain Measurement; D010166:Palliative Care / Q000379:methods*; D011788:Quality of Life; D011795:Surveys and Questionnaires
keywords: Bone metastases; Elderly; Pain response; Palliation; Quality of life; Radiotherapy