title: Tolerability and outcomes of curative radiotherapy in patients aged 85 or more years.
abstract: OBJECTIVE
  To assess the tolerability and survival outcome of curative radiotherapy in patients over the age of 85 years.
  
  
  METHODS
  Retrospective analysis of all patients aged over 85 years who received radiotherapy as part of curative treatment for any cancer (excluding insignificant skin cancers) at the Peter MacCallum Cancer Centre between 1 January 2000 and 1 January 2010.
  
  
  METHODS
  Poor treatment tolerability (defined as hospital admission during radiotherapy, treatment break, or early treatment cessation); predictors for poor treatment tolerability, overall survival and cancer-specific survival.
  
  
  RESULTS
  327 treatment courses met eligibility criteria. The median age of patients was 87 years. The most common treatment sites were pelvis (30%), head and neck (25%), and breast (18%). The Eastern Cooperative Oncology Group performance status (ECOG PS) score was 0 or 1 for 70% of patients. Overall, 79% of patients completed the prescribed treatment without poor treatment tolerability, and 95% of patients completed all treatment. Only unfavourable ECOG PS score (odds ratio [OR], 1.80; P = 0.005) and increasing age (OR, 1.18; P = 0.018) predicted poor treatment tolerability. ECOG PS score predicted overall survival (hazard ratio, 1.53; P = 0.001).
  
  
  CONCLUSIONS
  Age should not be the sole discriminator in decisions to prescribe aggressive loco-regional radiotherapy. ECOG PS score predicts for treatment tolerability, and also overall survival. The risk of cancer death was higher than non-cancer death for more than 5 years after treatment.
authors: Peter MacCallum Cancer Centre, Melbourne, VIC, Australia. richard.khor@petermac.org.
authors: Richard C
authors: RC
authors: Khor
authors: Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
authors: Mathias
authors: M
authors: Bressel
authors: Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
authors: Jo
authors: J
authors: Tedesco
authors: Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
authors: Keen Hun
authors: KH
authors: Tai
authors: Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
authors: David L
authors: DL
authors: Ball
authors: Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
authors: Gillian M
authors: GM
authors: Duchesne
authors: Victorian Cancer Registry, Cancer Council Victoria, Melbourne, VIC, Australia.
authors: Helen
authors: H
authors: Farrugia
authors: Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
authors: Wai Kuan
authors: WK
authors: Yip
authors: Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
authors: Farshad
authors: F
authors: Foroudi
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000532:radiotherapy; D059248:Chemoradiotherapy; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000532:radiotherapy; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000532:radiotherapy*; D010343:Patient Admission; D010386:Pelvic Neoplasms / Q000532:radiotherapy; D011836:Radiation Tolerance; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome