Browse > Article
http://dx.doi.org/10.3857/jkstro.2011.29.1.1

Radiotherapy in Elderly Patients with Cancer  

Chun, Mi-Son (Department of Radiation Oncology, Ajou University School of Medicine)
Jo, Sun-Mi (Department of Radiation Oncology, Ajou University School of Medicine)
Publication Information
Radiation Oncology Journal / v.29, no.1, 2011 , pp. 1-10 More about this Journal
Abstract
Due to improved life spans, cancer incidence has increased with more aged patients presenting with cancer. Elderly cancer patients could have compromised organ function and/or comorbidities. Due to poor social support or lack of early diagnosis, treatment outcomes for elderly cancer patients are poor in general. However, with aggressive support during cancer management as well as careful selection, most elderly cancer patients can tolerate standard radiation therapy with good results based on published articles. Here, we reviewed existing articles regarding compliance and treatment results in elderly cancer patients based on tumor site.
Keywords
Review; Elderly; Cancer; Radiation therapy;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Chen SW, Liang JA, Yang SN, et al. Radiation injury to intestine following hysterectomy and adjuvant radiotherapy for cervical cancer. Gynecol Oncol 2004;95:208-214   DOI   ScienceOn
2 Sandhu A, Mundt AJ. Radiation therapy for urologic malignancies in the elderly. Urol Oncol 2009;27:643-652   DOI   ScienceOn
3 Wong YN, Mitra N, Hudes G, et al. Survival associated with treatment vs observation of localized prostate cancer in elderly men. JAMA 2006;296:2683-2693   DOI   ScienceOn
4 Geinitz H, Zimmermann FB, Thamm R, Schumertl A, Busch R, Molls M. 3D conformal radiation therapy for prostate cancer in elderly patients. Radiother Oncol 2005;76:27-34   DOI   ScienceOn
5 Schofield CP, Sykes AJ, Slevin NJ, Rashid NZ. Radiotherapy for head and neck cancer in elderly patients. Radiother Oncol 2003;69:37-42   DOI   ScienceOn
6 Oguchi M, Ikeda H, Watanabe T, et al. Experiences of 23 patients >or =90 years of age treated with radiation therapy. Int J Radiat Oncol Biol Phys 1998;41:407-413   DOI
7 Rutten HJ, den Dulk M, Lemmens VE, van de Velde CJ, Marijnen CA. Controversies of total mesorectal excision for rectal cancer in elderly patients. Lancet Oncol 2008;9:494-501   DOI   ScienceOn
8 Dobie SA, Warren JL, Matthews B, Schwartz D, Baldwin LM, Billingsley K. Survival benefits and trends in use of adjuvant therapy among elderly stage II and III rectal cancer patients in the general population. Cancer 2008;112:789-799   DOI   ScienceOn
9 Pignon T, Horiot JC, Bolla M, et al. Age is not a limiting factor for radical radiotherapy in pelvic malignancies. Radiother Oncol 1997;42:107-120   DOI   ScienceOn
10 Kunos C, Tian C, Waggoner S, Rose PG, Lanciano R. Retrospective analysis of concomitant Cisplatin during radiation in patients aged 55 years or older for treatment of advanced cervical cancer: a gynecologic oncology group study. Int J Gynecol Cancer 2009;19:1258-1263   DOI   ScienceOn
11 Alektiar KM, Venkatraman E, Abu-Rustum N, Barakat RR. Is endometrial carcinoma intrinsically more aggressive in elderly patients? Cancer 2003;98:2368-2377   DOI   ScienceOn
12 Huscher A, Bignardi M, Magri E, et al. Determinants of small bowel toxicity in postoperative pelvic irradiation for gynaecological malignancies. Anticancer Res 2009;29:4821-4826
13 Yeh SA, Wan Leung S, Wang CJ, Chen HC. Postoperative radiotherapy in early stage carcinoma of the uterine cervix: treatment results and prognostic factors. Gynecol Oncol 1999;72:10-15   DOI   ScienceOn
14 Curran WJ Jr, Scott CB, Horton J, et al. Recursive partitioning analysis of prognostic factors in three Radiation Therapy Oncology Group malignant glioma trials. J Natl Cancer Inst 1993;85:704-710   DOI   ScienceOn
15 Mohan DS, Suh JH, Phan JL, Kupelian PA, Cohen BH, Barnett GH. Outcome in elderly patients undergoing definitive surgery and radiation therapy for supratentorial glioblastoma multiforme at a tertiary care institution. Int J Radiat Oncol Biol Phys 1998;42:981-987   DOI   ScienceOn
16 Bouchardy C, Rapiti E, Fioretta G, et al. Undertreatment strongly decreases prognosis of breast cancer in elderly women. J Clin Oncol 2003;21:3580-3587   DOI   ScienceOn
17 Albrand G, Terret C. Early breast cancer in the elderly: assessment and management considerations. Drugs Aging 2008;25:35-45   DOI   ScienceOn
18 Silliman RA. When cancer in older adults is undermanaged: the breast cancer story. J Am Geriatr Soc 2009;57(Suppl 2):S259-S261   DOI
19 Alberg AJ, Singh S. Epidemiology of breast cancer in older women: implications for future healthcare. Drugs Aging 2001;18:761-772   DOI   ScienceOn
20 Sanghani M, Balk EM, Cady B. Impact of axillary lymph node dissection on breast cancer outcome in clinically node negative patients: a systematic review and meta-analysis. Cancer 2009;115:1613-1620   DOI   ScienceOn
21 Martelli G, Miceli R, De Palo G, et al. Is axillary lymph node dissection necessary in elderly patients with breast carcinoma who have a clinically uninvolved axilla? Cancer 2003;97:1156-1163   DOI   ScienceOn
22 Veronesi U, Marubini E, Mariani L, et al. Radiotherapy after breast-conserving surgery in small breast carcinoma: long-term results of a randomized trial. Ann Oncol 2001;12:997-1003   DOI   ScienceOn
23 Livi L, Paiar F, Meldolesi E, et al. The management of elderly patients with T1-T2 breast cancer treated with or without radiotherapy. Eur J Surg Oncol 2005;31:473-478   DOI   ScienceOn
24 Smith BD, Gross CP, Smith GL, Galusha DH, Bekelman JE, Haffty BG. Effectiveness of radiation therapy for older women with early breast cancer. J Natl Cancer Inst 2006;98:681-690   DOI   ScienceOn
25 Hughes KS, Schnaper LA, Berry D, et al. Lumpectomy plus tamoxifen with or without irradiation in women 70 years of age or older with early breast cancer. N Engl J Med 2004;351:971-977   DOI   ScienceOn
26 Smith BD, Arthur DW, Buchholz TA, et al. Accelerated partial breast irradiation consensus statement from the American Society for Radiation Oncology (ASTRO). Int J Radiat Oncol Biol Phys 2009;74:987-1001   DOI   ScienceOn
27 Smith BD, Haffty BG, Hurria A, Galusha DH, Gross CP. Postmastectomy radiation and survival in older women with breast cancer. J Clin Oncol 2006;24:4901-4907   DOI   ScienceOn
28 Nguyen PL, Chen MH, Renshaw AA, Loffredo M, Kantoff PW, D'Amico AV. Survival following radiation and androgen suppression therapy for prostate cancer in healthy older men: implications for screening recommendations. Int J Radiat Oncol Biol Phys 2010;76:337-341   DOI   ScienceOn
29 Jani AB, Parikh SD, Vijayakumar S, Gratzle J. Analysis of influence of age on acute and chronic radiotherapy toxicity in treatment of prostate cancer. Urology 2005;65:1157-1162   DOI   ScienceOn
30 Droz JP, Balducci L, Bolla M, et al. Background for the proposal of SIOG guidelines for the management of prostate cancer in senior adults. Crit Rev Oncol Hematol 2010;73:68-91   DOI   ScienceOn
31 Hayes JH, Chen MH, Moran BJ, et al. Androgen-suppression therapy for prostate cancer and the risk of death in men with a history of myocardial infarction or stroke. BJU Int 2010;106:979-985   DOI   ScienceOn
32 Tsai HK, D'Amico AV, Sadetsky N, Chen MH, Carroll PR. Androgen deprivation therapy for localized prostate cancer and the risk of cardiovascular mortality. J Natl Cancer Inst 2007;99:1516-1524   DOI   ScienceOn
33 Balducci L, Yates J. General guidelines for the management of older patients with cancer. Oncology (Williston Park) 2000;14:221-227
34 Syrigos KN, Karachalios D, Karapanagiotou EM, Nutting CM, Manolopoulos L, Harrington KJ. Head and neck cancer in the elderly: an overview on the treatment modalities. Cancer Treat Rev 2009;35:237-245   DOI   ScienceOn
35 Pignon T, Horiot JC, Van den Bogaert W, Van Glabbeke M, Scalliet P. No age limit for radical radiotherapy in head and neck tumours. Eur J Cancer 1996;32A:2075-2081
36 Huguenin P, Sauer M, Glanzmann C, Lutolf UM. Radiotherapy for carcinomas of the head and neck in elderly patients. Strahlenther Onkol 1996;172:485-488
37 Thomas R, James N, Guerrero D, Ashley S, Gregor A, Brada M. Hypofractionated radiotherapy as palliative treatment in poor prognosis patients with high grade glioma. Radiother Oncol 1994;33:113-116   DOI   ScienceOn
38 Keime-Guibert F, Chinot O, Taillandier L, et al. Radiotherapy for glioblastoma in the elderly. N Engl J Med 2007;356:1527-1535   DOI   ScienceOn
39 Roa W, Brasher PM, Bauman G, et al. Abbreviated course of radiation therapy in older patients with glioblastoma multiforme: a prospective randomized clinical trial. J Clin Oncol 2004;22:1583-1588   DOI   ScienceOn
40 Bauman GS, Gaspar LE, Fisher BJ, Halperin EC, Macdonald DR, Cairncross JG. A prospective study of short-course radiotherapy in poor prognosis glioblastoma multiforme. Int J Radiat Oncol Biol Phys 1994;29:835-839   DOI   ScienceOn
41 Ford JM, Stenning SP, Boote DJ, et al. A short fractionation radiotherapy treatment for poor prognosis patients with high grade glioma. Clin Oncol (R Coll Radiol) 1997;9:20-24   DOI   ScienceOn
42 Lutterbach J, Ostertag C. What is the appropriate radiotherapy protocol for older patients with newly diagnosed glioblastoma? J Clin Oncol 2005;23:2869-2870   DOI
43 Roa W, Xing JZ, Small C, et al. Current developments in the radiotherapy approach to elderly and frail patients with glioblastoma multiforme. Expert Rev Anticancer Ther 2009;9:1643-1650   DOI   ScienceOn
44 Sijben AE, McIntyre JB, Roldan GB, et al. Toxicity from chemoradiotherapy in older patients with glioblastoma multiforme. J Neurooncol 2008;89:97-103   DOI   ScienceOn
45 Combs SE, Wagner J, Bischof M, et al. Postoperative treatment of primary glioblastoma multiforme with radiation and concomitant temozolomide in elderly patients. Int J Radiat Oncol Biol Phys 2008;70:987-992   DOI   ScienceOn
46 Minniti G, De Sanctis V, Muni R, et al. Hypofractionated radiotherapy followed by adjuvant chemotherapy with temozolomide in elderly patients with glioblastoma. J Neurooncol 2009;91:95-100   DOI   ScienceOn
47 Clough-Gorr KM, Stuck AE, Thwin SS, Silliman RA. Older breast cancer survivors: geriatric assessment domains are associated with poor tolerance of treatment adverse effects and predict mortality over 7 years of follow-up. J Clin Oncol 2010;28:380-386   DOI   ScienceOn
48 Coiffier B, Lepage E, Briere J, et al. CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. N Engl J Med 2002;346:235-242   DOI   ScienceOn
49 Ashcroft GS, Horan MA, Ferguson MW. Aging alters the inflammatory and endothelial cell adhesion molecule profiles during human cutaneous wound healing. Lab Invest 1998;78:47-58
50 Yancik R. Cancer burden in the aged: an epidemiologic and demographic overview. Cancer 1997;80:1273-1283   DOI   ScienceOn
51 Muss HB, Woolf S, Berry D, et al. Adjuvant chemotherapy in older and younger women with lymph node-positive breast cancer. JAMA 2005;293:1073-1081   DOI   ScienceOn
52 Goodwin JS, Samet JM, Hunt WC. Determinants of survival in older cancer patients. J Natl Cancer Inst 1996;88:1031-1038   DOI   ScienceOn
53 Bouvier AM, Launoy G, Lepage C, Faivre J. Trends in the management and survival of digestive tract cancers among patients aged over 80 years. Aliment Pharmacol Ther 2005;22:233-241   DOI   ScienceOn
54 Vercelli M, Capocaccia R, Quaglia A, Casella C, Puppo A, Coebergh JW. Relative survival in elderly European cancer patients: evidence for health care inequalities. The EUROCARE Working Group. Crit Rev Oncol Hematol 2000;35:161-179   DOI   ScienceOn
55 Repetto L, Fratino L, Audisio RA, et al. Comprehensive geriatric assessment adds information to Eastern Cooperative Oncology Group performance status in elderly cancer patients: an Italian Group for Geriatric Oncology Study. J Clin Oncol 2002;20:494-502   DOI   ScienceOn
56 Gomez H, Hidalgo M, Casanova L, et al. Risk factors for treatment-related death in elderly patients with aggressive non-Hodgkin's lymphoma: results of a multivariate analysis. J Clin Oncol 1998;16:2065-2069   DOI
57 Appelbaum FR, Gundacker H, Head DR, et al. Age and acute myeloid leukemia. Blood 2006;107:3481-3485   DOI   ScienceOn
58 Wedding U, Rohrig B, Klippstein A, Fricke HJ, Sayer HG, Hoffken K. Impairment in functional status and survival in patients with acute myeloid leukaemia. J Cancer Res Clin Oncol 2006;132:665-671   DOI   ScienceOn
59 Werner-Wasik M, Scott C, Cox JD, et al. Recursive partitioning analysis of 1999 Radiation Therapy Oncology Group (RTOG) patients with locally-advanced non-small-cell lung cancer (LA-NSCLC): identification of five groups with different survival. Int J Radiat Oncol Biol Phys 2000;48:1475-1482   DOI   ScienceOn
60 Yu HM, Liu YF, Yu JM, Liu J, Zhao Y, Hou M. Involved-field radiotherapy is effective for patients 70 years old or more with early stage non-small cell lung cancer. Radiother Oncol 2008;87:29-34   DOI   ScienceOn
61 Jatoi A, Hillman S, Stella P, et al. Should elderly non-small-cell lung cancer patients be offered elderly-specific trials? Results of a pooled analysis from the North Central Cancer Treatment Group. J Clin Oncol 2005;23:9113-9119   DOI   ScienceOn
62 Schild SE, Stella PJ, Geyer SM, et al. The outcome of combined-modality therapy for stage III non-small-cell lung cancer in the elderly. J Clin Oncol 2003;21:3201-3206   DOI   ScienceOn
63 Non-small Cell Lung Cancer Collaborative Group. Chemotherapy in non-small cell lung cancer: a meta-analysis using updated data on individual patients from 52 randomised clinical trials. BMJ 1995;311:899-909   DOI   ScienceOn
64 Movsas B, Scott C, Sause W, et al. The benefit of treatment intensification is age and histology-dependent in patients with locally advanced non-small cell lung cancer (NSCLC): a quality-adjusted survival analysis of radiation therapy oncology group (RTOG) chemoradiation studies. Int J Radiat Oncol Biol Phys 1999;45:1143-1149   DOI   ScienceOn
65 Langer CJ, Hsu C, Curran WJ, et al. Elderly patients (pts) with locally advanced non-small cell lung cancer (LA-NSCLC) benefit from conbined modality therpy: secondary analysis of Radiation Therapy Oncology Group (RTOG) 94-10. Proc Am Soc Clin Oncol 2002;21:abstr1193
66 Redmond KJ, Song DY. Thoracic irradiation in the elderly. Thorac Surg Clin 2009;19:391-400   DOI   ScienceOn
67 Scott CB, Scarantino C, Urtasun R, et al. Validation and predictive power of Radiation Therapy Oncology Group (RTOG) recursive partitioning analysis classes for malignant glioma patients: a report using RTOG 90-06. Int J Radiat Oncol Biol Phys 1998;40:51-55   DOI   ScienceOn
68 Lin LL, Hahn SM. Combined modality therapy in the elderly population. Curr Treat Options Oncol 2009;10:195-204   DOI
69 Horiot JC. Radiation therapy and the geriatric oncology patient. J Clin Oncol 2007;25:1930-1935   DOI   ScienceOn
70 Klepin HD, Geiger AM, Tooze JA, et al. Physical performance and subsequent disability and survival in older adults with malignancy: results from the health, aging and body composition study. J Am Geriatr Soc 2010;58:76-82   DOI   ScienceOn
71 Bellizzi KM, Mustian KM, Palesh OG, Diefenbach M. Cancer survivorship and aging: moving the science forward. Cancer 2008;113(12 Suppl):3530-3539   DOI
72 Boss GR, Seegmiller JE. Age-related physiological changes and their clinical significance. West J Med 1981;135:434-440
73 Brandtstadter J, Renner G. Tenacious goal pursuit and flexible goal adjustment: explication and age-related analysis of assimilative and accommodative strategies of coping. Psychol Aging 1990;5:58-67   DOI
74 Blank TO, Bellizzi KM. A gerontologic perspective on cancer and aging. Cancer 2008;112(11 Suppl):2569-2576   DOI
75 Arndt V, Merx H, Sturmer T, Stegmaier C, Ziegler H, Brenner H. Age-specific detriments to quality of life among breast cancer patients one year after diagnosis. Eur J Cancer 2004;40:673-680   DOI   ScienceOn
76 Paulino AC, Constine LS, Rubin P, Williams JP. Normal tissue development, homeostasis, senescence, and the sensitivity to radiation injury across the age spectrum. Semin Radiat Oncol 2010;20:12-20   DOI   ScienceOn
77 Gouin JP, Hantsoo L, Kiecolt-Glaser JK. Immune dysregulation and chronic stress among older adults: a review. Neuroimmunomodulation 2008;15:251-259   DOI   ScienceOn
78 Ferrucci L, Harris TB, Guralnik JM, et al. Serum IL-6 level and the development of disability in older persons. J Am Geriatr Soc 1999;47:639-646   DOI
79 Ogata K, Yokose N, Tamura H, et al. Natural killer cells in the late decades of human life. Clin Immunol Immunopathol 1997;84:269-275   DOI   ScienceOn
80 Bernstein E, Kaye D, Abrutyn E, Gross P, Dorfman M, Murasko DM. Immune response to influenza vaccination in a large healthy elderly population. Vaccine 1999;17:82-94   DOI   ScienceOn
81 Gosain A, DiPietro LA. Aging and wound healing. World J Surg 2004;28:321-326   DOI   ScienceOn
82 Gravenstein S, Drinka P, Duthie EH, et al. Efficacy of an influenza hemagglutinin-diphtheria toxoid conjugate vaccine in elderly nursing home subjects during an influenza outbreak. J Am Geriatr Soc 1994;42:245-251   DOI
83 Ershler WB, Keller ET. Age-associated increased interleukin-6 gene expression, late-life diseases, and frailty. Annu Rev Med 2000;51:245-270   DOI   ScienceOn
84 Pignon T, Gregor A, Schaake Koning C, Roussel A, Van Glabbeke M, Scalliet P. Age has no impact on acute and late toxicity of curative thoracic radiotherapy. Radiother Oncol 1998;46:239-248   DOI   ScienceOn
85 National Cancer Information Center. Cancer statistics [Internet]. Goyang: National Cancer Information Center; [cited 2011 Jan 20]. Available from: http://www.cancer.go.kr/cms/statistics/survival_rate