title: Portrait, treatment choices and management of breast cancer in nonagenarians: an ongoing challenge.
abstract: There are only scarce data on the management of nonagenarians with breast cancer, and more particularly on the place of radiation therapy (RT). We report a retrospective study on patients aged 90 years old or older, with breast cancer, receiving RT. Records from RT departments from five institutions were reviewed to identify patients 90 years old of age and older undergoing RT over past decade for breast cancer. Tumors' characteristics were examined, as well treatment specificities and treatment intent. 44 patients receiving RT courses were identified, mean age 92 years. Treatment was given with curative and palliative intent in 72.7% and 27.3% respectively. Factors associated with a curative treatment were performance status (PS), place of life, previous surgery, and tumor stage. Median total prescribed dose was 40 Gy (23-66). Hypo fractionation was used in 77%. Most toxicities were mild to moderate. RT could not be completed in 1 patient (2.3%). No long-term toxicity was reported. Among 31 patients analyzable for effectiveness, 24 patients (77.4%) had their diseased controlled until last follow-up, including 17 patients (54.8%) experiencing complete response. At last follow-up, 4 patients (12.9%) were deceased, cancer being cause of death for two of them. The study shows that breast/chest RT is feasible in nonagenarians. Although the definitive benefit of RT could not be addressed here, hypofractionated therapy allowed a good local control with acceptable side effects.
authors.affiliation: Departement of Medical Oncology, Institut Lucien Neuwirth, St. Priest en Jarez Cedex, France.
authors.forename: Benoite
authors.initials: B
authors.lastname: Méry
authors.affiliation: Department of Radiotherapy, Clinical Center of Porte de Saint Cloud, Boulogne-Billancourt, France.
authors.forename: Avi
authors.initials: A
authors.lastname: Assouline
authors.affiliation: Departement of Medical Oncology, Institut Lucien Neuwirth, St. Priest en Jarez Cedex, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Rivoirard
authors.affiliation: Departement of Medical Oncology, Institut Lucien Neuwirth, St. Priest en Jarez Cedex, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Bosacki
authors.affiliation: Department of Radiotherapy, Clinique Claude Bernard, Albi, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Auberdiac
authors.affiliation: Departement of Radiotherapy, Centre Antoine Lacassagne, Nice, France.
authors.forename: Alexander T
authors.initials: AT
authors.lastname: Falk
authors.affiliation: Departement of Radiotherapy, Institut Lucien Neuwirth, St. Priest en Jarez Cedex, France.
authors.forename: Jane-Chloé
authors.initials: JC
authors.lastname: Trone
authors.affiliation: Departement of Radiotherapy, Institut Lucien Neuwirth, St. Priest en Jarez Cedex, France.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Guy
authors.affiliation: Departement of Medical Oncology, Institut Lucien Neuwirth, St. Priest en Jarez Cedex, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Jacquin
authors.affiliation: Departement of Medical Oncology, Institut Lucien Neuwirth, St. Priest en Jarez Cedex, France.
authors.forename: Yacine
authors.initials: Y
authors.lastname: Merrouche
authors.affiliation: Department of Radiotherapy, Instruction Armed Val-de-Grace Hospital, Paris 75230, France.
authors.forename: Cyrus
authors.initials: C
authors.lastname: Chargari
authors.affiliation: Departement of Radiotherapy, Institut Lucien Neuwirth, St. Priest en Jarez Cedex, France. Electronic address: nicolas.Magne@icloire.fr.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Magné
mesh_terms: D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D019468:Disease Management; D019583:Dose Fractionation, Radiation; D005260:Female; D005602:France / Q000453:epidemiology; D015577:Geriatric Assessment; D006801:Humans; D009367:Neoplasm Staging; D010166:Palliative Care; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D064890:Social Determinants of Health; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Breast cancer; Elderly; Nonagenarians; Radiation therapy