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.
Highlights
Radiotherapy is a cornerstone in the management of gynecologic cancer
Because patients 65 years of age or older are often excluded from clinical trials, little is known about the therapeutic index of radiotherapy in the geriatric population [1]
One late grade 2 toxicity was observed. Based on these real-life findings, radiotherapy seems feasible in nonagenarian patients, either with intent to cure or in palliative setting
Summary
Radiotherapy is a cornerstone in the management of gynecologic cancer. Because patients 65 years of age or older are often excluded from clinical trials, little is known about the therapeutic index (efficacy/toxicity ratio) of radiotherapy in the geriatric population [1]. For patients at high risk of local recurrence or who have unresectable or locally advanced disease, radiotherapy can be performed with the intent to cure [2–6]. Radiotherapy can be performed in a palliative setting. A few studies reported radiotherapy-caused complications in nonagenarian patients, but data on efficacy are still scarce. The objective of the present study was to report efficacy and toxicity data on the radiotherapy treatment of nonagenarian patients with gynecologic cancer
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