title: Carcinoma of the cervix in elderly patients treated with radiotherapy: patterns of care and treatment outcomes.
abstract: OBJECTIVE
  The aim of this analysis was to examine the management of cervix cancer in elderly patients referred for radiotherapy and the results of treatment in terms of overall survival (OS), relapse-free survival (RFS), and treatment-related toxicities.
  
  
  METHODS
  Patients were eligible if they were aged ≥75 years, newly diagnosed with cervix cancer and referred for radiotherapy as part of their treatment. Patient details were retrieved from the gynaecology service database where clinical, histopathological treatment and follow-up data were prospectively collected.
  
  
  RESULTS
  From 1998 to 2010, 126 patients aged ≥75 years, met selection criteria. Median age was 81.5 years. Eighty-one patients had definitive radiotherapy, 10 received adjuvant radiotherapy and 35 had palliative radiotherapy. Seventy-one percent of patients had the International Federation of Gynecology and Obstetrics stage 1b-2b disease. Median follow-up was 37 months. OS and RFS at 3 years among those treated with curative intent were 66.6% and 75.9% respectively with majority of patients dying without any evidence of cervix cancer. Grade 2 or more late toxicities were: bladder 5%, bowel 11%, and vagina 27%. Eastern Cooperative Oncology Group (ECOG) status was a significant predictor of OS and RFS with each unit increment in ECOG score increased the risk of death by 1.69 times (p<0.001).
  
  
  CONCLUSIONS
  Following appropriate patient selection, elderly patients treated curatively with radiotherapy for cervix cancer have good disease control. Palliative hypofractionated regimens are well tolerated in patients unsuitable for radical treatment.
authors.affiliation: Gynae-Oncology Unit, Department of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia. Ming-Yin.Lin@petermac.org.
authors.forename: Ming Yin
authors.identifier: http://orcid.org/0000-0003-2416-7326
authors.initials: MY
authors.lastname: Lin
authors.affiliation: Gynae-Oncology Unit, Department of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia.|Rural Clinical School, The University of Queensland School of Medicine, Toowoomba, Queensland, Australia.
authors.forename: Srinivas
authors.initials: S
authors.lastname: Kondalsamy-Chennakesavan
authors.affiliation: Gynae-Oncology Unit, Department of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Bernshaw
authors.affiliation: Gynae-Oncology Unit, Department of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia.
authors.forename: Pearly
authors.initials: P
authors.lastname: Khaw
authors.affiliation: Gynae-Oncology Unit, Department of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia.|Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Kailash
authors.initials: K
authors.lastname: Narayan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D009367:Neoplasm Staging; D010166:Palliative Care; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D015996:Survival Rate; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*
keywords: Aged; Brachytherapy; Radiotherapy; Uterine Cervical Neoplasms