title: Radiotherapy for gynecologic cancer in nonagenarian patients: a framework for new paradigms.
abstract: No consensus exists regarding the role of radiotherapy in the management of gynecologic cancer in nonagenarian patients. We retrospectively reviewed the outcomes of 19 consecutive nonagenarian patients with gynecologic cancer (6 endometrial cancers, 6 cervical cancers, 4 vulvar cancers, and 3 vaginal cancers) who were treated with radiotherapy. Radiotherapy was performed mainly in a palliative setting (n = 12; 63.2%), with a median dose of 45 Gy (range, 6-76 Gy). Infrequent major acute or late toxicities were reported. Among 19 patients, 9 (47.4%) experienced tumor progression, 5 (26.3%) experienced complete response, 2 (10.5%) experienced stable disease and/or partial response. At last follow-up, 12 patients (63.2%) had died; most deaths (n = 9) occurred because of the cancer. These results suggest that radiotherapy is feasible in the treatment of nonagenarian patients with gynecologic cancer.
authors.affiliation: Department of Medical Oncology, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France.
authors.forename: Benoîte
authors.initials: B
authors.lastname: Méry
authors.affiliation: Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France.
authors.forename: Sylvie Mengue
authors.initials: SM
authors.lastname: Ndong
authors.affiliation: Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Guy
authors.affiliation: Department of Radiotherapy, Porte De Saint Cloud Clinical Center, 92100, Boulogne-Billancourt, France.
authors.forename: Avi
authors.initials: A
authors.lastname: Assouline
authors.affiliation: Department of Radiation Oncology, Antoine Lacassagne Center, 06100, Nice, France.
authors.forename: Alexander T
authors.initials: AT
authors.lastname: Falk
authors.affiliation: Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France.
authors.forename: Anaïs
authors.initials: A
authors.lastname: Valeille
authors.affiliation: Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France.
authors.forename: Jane-Chloé
authors.initials: JC
authors.lastname: Trone
authors.affiliation: Department of Medical Oncology, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Rivoirard
authors.affiliation: Department of Radiotherapy, Claude Bernard Private Hospital, 81000, Albi, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Auberdiac
authors.affiliation: Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France.
authors.forename: Alexis
authors.initials: A
authors.lastname: Vallard
authors.affiliation: Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Espenel
authors.affiliation: Department of Medical Oncology, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Moriceau
authors.affiliation: Department of Medical Oncology, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Collard
authors.affiliation: Department of Medical Oncology, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Bosacki
authors.affiliation: Department of Medical Oncology, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Jacquin
authors.affiliation: Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France.
authors.forename: Guy
authors.initials: G
authors.lastname: de Laroche
authors.affiliation: Department of Medical Oncology, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Fournel
authors.affiliation: Department of Radiotherapy, Val-De-Grâce Military Hospital, 75230, Paris, France.
authors.forename: Cyrus
authors.initials: C
authors.lastname: Chargari
authors.affiliation: Department of Radiotherapy, Lucien Neuwirth Cancer Institute, 42271, Saint Priest En Jarez, France. nicolas.magne@icloire.fr.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Magné
mesh_terms: D000369:Aged, 80 and over; D016889:Endometrial Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D010166:Palliative Care / Q000379:methods; D011878:Radiotherapy / Q000009:adverse effects; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D014625:Vaginal Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D014846:Vulvar Neoplasms / Q000401:mortality / Q000532:radiotherapy*
keywords: Female genital tract; Geriatrics; Gynecologic cancer; Nonagenarians; Radiotherapy