title: Concurrent chemo-radiotherapy in elderly patients: tolerance and compliance in a series of 137 patients.
abstract: BACKGROUND
  Aggressive cancer treatment is a challenge in elderly patients. The present study aims to assess tolerance in terms of acute toxicity and compliance of concurrent chemo-radiotherapy (cCRT) in a series of patients aged ≥70 years.
  
  
  METHODS
  Clinical records of patients aged ≥70 years who underwent cCRT between January 2005 and December 2013 were reviewed. Concurrent CRT had curative intent in 134 patients (97.8 %) and palliative intent in 3 patients (2.2 %). Chemotherapy (CT) drugs and schedule were selected according to tumor histology. Radiotherapy median dose was 45.0 Gy (range 11-70 Gy) for curative purposes and 54 Gy (range 40-56 Gy) for palliative purposes. Incidence of acute toxicity and compliance to cCRT were analyzed and correlated with age, Karnofsky Performance Status (KPS), and Charlson Comorbidity Index (CCI).
  
  
  RESULTS
  Overall, 137 patients, 82 males (60 %) and 55 females (40 %), median age 74 years (range 70-90 years) were analyzed. Concurrent CRT schedule was completed by 132 patients (96.4 %). Thirty-one of these patients (23.5 %) temporarily interrupted treatment. Hematological toxicity with grade ≥1 was observed in 25 patients (18.2 %), gastrointestinal toxicity in 55 (40.1 %), and genitourinary in 13 (9.5 %). Mucositis with grade ≥1 was recorded in 19 patients (13.9 %). No statistical significant correlation between KPS, CCI, and toxicity was found. A correlation trend between mucositis and patient age (p = 0.05) was observed.
  
  
  CONCLUSIONS
  Concurrent CRT for elderly was feasible and quite well tolerated. Great attention in prescribing CT dose should be paid to limit acute toxicity.
authors.affiliation: Chair of Radiotherapy, Division of Radiotherapy, Department of Translational Medicine, University Hospital "Maggiore della Carità", University of "Piemonte Orientale", Via Solaroli, 17, 28100, Novara, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Di Genesio Pagliuca
authors.affiliation: Chair of Radiotherapy, Division of Radiotherapy, Department of Translational Medicine, University Hospital "Maggiore della Carità", University of "Piemonte Orientale", Via Solaroli, 17, 28100, Novara, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Perotti
authors.affiliation: Chair of Radiotherapy, Division of Radiotherapy, Department of Translational Medicine, University Hospital "Maggiore della Carità", University of "Piemonte Orientale", Via Solaroli, 17, 28100, Novara, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Apicella
authors.affiliation: Chair of Radiotherapy, Division of Radiotherapy, Department of Translational Medicine, University Hospital "Maggiore della Carità", University of "Piemonte Orientale", Via Solaroli, 17, 28100, Novara, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Galla
authors.affiliation: Chair of Radiotherapy, Division of Radiotherapy, Department of Translational Medicine, University Hospital "Maggiore della Carità", University of "Piemonte Orientale", Via Solaroli, 17, 28100, Novara, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Guffi
authors.affiliation: Chair of Radiotherapy, Division of Radiotherapy, Department of Translational Medicine, University Hospital "Maggiore della Carità", University of "Piemonte Orientale", Via Solaroli, 17, 28100, Novara, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Paolini
authors.affiliation: Chair of Radiotherapy, Division of Radiotherapy, Department of Translational Medicine, University Hospital "Maggiore della Carità", University of "Piemonte Orientale", Via Solaroli, 17, 28100, Novara, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Donis
authors.affiliation: Chair of Radiotherapy, Division of Radiotherapy, Department of Translational Medicine, University Hospital "Maggiore della Carità", University of "Piemonte Orientale", Via Solaroli, 17, 28100, Novara, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Amisano
authors.affiliation: Chair of Radiotherapy, Division of Radiotherapy, Department of Translational Medicine, University Hospital "Maggiore della Carità", University of "Piemonte Orientale", Via Solaroli, 17, 28100, Novara, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Torrente
authors.affiliation: Chair of Radiotherapy, Division of Radiotherapy, Department of Translational Medicine, University Hospital "Maggiore della Carità", University of "Piemonte Orientale", Via Solaroli, 17, 28100, Novara, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Manfredda
authors.affiliation: Chair of Radiotherapy, Division of Radiotherapy, Department of Translational Medicine, University Hospital "Maggiore della Carità", University of "Piemonte Orientale", Via Solaroli, 17, 28100, Novara, Italy. krengli@med.unipmn.it.
authors.forename: M
authors.initials: M
authors.lastname: Krengli
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000628:therapy*; D010349:Patient Compliance; D012189:Retrospective Studies
keywords: Chemo-radiotherapy; Compliance; Elderly; Toxicity