title: Survival after palliative radiotherapy in geriatric cancer patients.
abstract: OBJECTIVE
  Older cancer patients might experience inferior survival outcomes. However, no standard age cut-off is currently being used for commonly administered treatments such as radiotherapy. We evaluated survival outcomes and prognostic factors for survival after palliative radiotherapy (PRT) in our oldest patients (age≥80 years).
  
  
  METHODS
  This retrospective study covered the time period between 2007 and 2012, and included 94 patients in this age group who were treated with PRT. Comparisons to a group of younger patients (31-79 years of age, N=445) treated during the same time period were made. Uni- and multivariate analyses were also performed. Most patients received PRT for bone and brain metastases or in order to improve thoracic symptoms from lung cancer.
  
  
  RESULTS
  Median age was 83 years. Survival outcomes and rates of PRT completion were not significantly different. Short median survival of less than 2 months was observed in two sub-groups of geriatric patients; those with brain metastases and those with Eastern Cooperative Oncology Group (ECOG) performance status (PS) 4. Multivariate analysis confirmed the prognostic impact of PS, adrenal gland metastases, progressive disease outside PRT target volume(s), need for opioid analgetics and steroids (all p<0.05). Brain metastasis was associated with a borderline increase in risk of mortality (p=0.051).
  
  
  CONCLUSIONS
  Our data support utilization of PRT irrespective of age for most patients with PS 0-3 but care should be taken in selecting the right fractionation regimen in order to avoid lengthy PRT courses when survival is limited.
authors.affiliation: Department of Oncology and Palliative Medicine, Nordland Hospital, Bodø, Norway Institute of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway carsten.nieder@nlsh.no.
authors.forename: Carsten
authors.initials: C
authors.lastname: Nieder
authors.affiliation: Institute of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway.
authors.forename: Kent
authors.initials: K
authors.lastname: Angelo
authors.affiliation: Department of Oncology and Palliative Medicine, Nordland Hospital, Bodø, Norway.
authors.forename: Ellinor
authors.initials: E
authors.lastname: Haukland
authors.affiliation: Department of Oncology and Palliative Medicine, Nordland Hospital, Bodø, Norway.
authors.forename: Adam
authors.initials: A
authors.lastname: Pawinski
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000401:mortality* / Q000532:radiotherapy / Q000556:secondary; D001932:Brain Neoplasms / Q000401:mortality* / Q000532:radiotherapy / Q000556:secondary; D016022:Case-Control Studies; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality* / Q000532:radiotherapy / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009369:Neoplasms / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy; D010166:Palliative Care; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
keywords: Palliative radiotherapy; age; comorbidity; geriatric patients; octogenarians; prognostic factors