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Strahlentherapie und Onkologie

, Volume 195, Issue 1, pp 62–68 | Cite as

Feasibility of radiotherapy in nonagenarian patients: a retrospective study

  • L. Kocik
  • H. Geinitz
  • C. Track
  • M. Geier
  • C. Nieder
Original Article
  • 40 Downloads

Abstract

Purpose

Specific information about radiation therapy in nonagenarians is limited. In order to shed more light on the feasibility of radiotherapy in this challenging subgroup, a retrospective study was performed.

Methods

The data of 93 consecutive patients receiving irradiation treatment at the Department of Radiation Oncology, Ordensklinikum Linz Barmherzige Schwestern between June 2005 and December 2016 were analyzed. Patient- and treatment-related factors were extracted from the patient records. Overall survival (OS) was defined as time from irradiation to death or last follow-up. The survival rates were analyzed using the Kaplan-Meier method and log-rank test.

Results

The study population of 93 patients was between 90 and 99 years old (median 91 years). It included 59 women (63%) and 34 men (37%). Of these, 38 (41%) received definitive radiotherapy, 14 (15%) received neoadjuvant or adjuvant radiotherapy, whereas a palliative regimen was prescribed in 44% of the cases (n = 41). In all, 79 patients (85%) were able to complete their prescribed course of radiotherapy. While 16 (17%) patients reported grade 2 toxicities or higher, 4 had ≥grade 3 side effects (4%). The median survival was significantly higher in patients treated with adjuvant, neoadjuvant or definitive radiotherapy (13.8 months) compared to patients treated with palliative radiotherapy (3.6 months; p < 0.001).

Conclusion

Even in patients managed without preradiotherapy comprehensive geriatric assessment, carefully planned fractionated radiotherapy was feasible and resulted in acceptable rates of acute toxicities.

Keywords

Aged, 80 and over Radiation Oncology Geriatric assessment Dose Fractionation Survival Rate 

Strahlentherapie bei „Nonagenerians“: eine retrospektive Machbarkeitsstudie

Zusammenfassung

Hintergrund

In der Literatur sind nur eingeschränkt Daten zu Strahlentherapie für „Nonagenerians“ verfügbar. Um die Durchführbarkeit einer Strahlentherapie in dieser Population beurteilen zu können, wurde diese retrospektive Analyse durchgeführt.

Methoden

Die Daten von 93 Patienten, die im Zeitraum von Juni 2005 bis Dezember 2016 an der Abteilung für Radioonkologie im Ordensklinikum Linz Barmherzige Schwestern eine Strahlentherapie erhielten, wurden retrospektiv ausgewertet. Behandlungs- und Patientendaten wurden den Krankenakten entnommen. Das Gesamtüberleben („overall survival“, OS) wurde definiert als die Zeit von der Behandlung bis zum Zeitpunkt entweder des Versterbens oder des letzten Follow-up. Die Analyse der Überlebensdaten erfolgte nach Kaplan-Meier und unter Verwendung des Log-rank-Testverfahrens.

Ergebnisse

Die Studienpopulation war zwischen 90 und 99 Jahre alt (Median 91), eingeschlossen wurden 59 weibliche (63 %) und 34 männliche (37 %) Patienten. Von diesen wurden 38 (41 %) definitiv behandelt, 14 (15 %) adjuvant oder neoadjuvant, eine palliative Behandlung erhielten 41 Patienten (44 %). Insgesamt konnten 79 Patienten (85 %) die verordnete Radiotherapie abschließen. Grad-2-Nebenwirkungen oder stärkere beschrieben 16 (17 %) Patienten, 4 (4 %) hatten ≥Grad-3-Toxizitäten. Das mediane Überleben der Patienten, die eine definitive, neoadjuvante oder adjuvante Radiotherapie erhalten hatten, war mit 13,8 Monaten im Vergleich zu dem der palliativ therapierten Patienten (3,8 Monate) signifikant höher (p < 0,001).

Schlussfolgerung

Auch bei Patienten, die zuvor keinem ausführlichen geriatrischen Assessment unterzogen wurden, war eine sorgsam geplante fraktionierte Strahlentherapie – mit einer akzeptablen Rate an akuten therapieassoziierten Nebenwirkungen – gut durchführbar.

Schlüsselwörter

Alter, 80 und höher Radioonkologie Geriatrisches Assessment Dosisfraktionierung Überlebensraten 

Notes

Compliance with ethical guidelines

Conflict of interest

L. Kocik, H. Geinitz, C. Track, M. Geier and C. Nieder declare that they have no competing interests.

Ethical standards

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Radiation OncologyOrdensklinikum Linz Barmherzige SchwesternLinzAustria
  2. 2.Department of Oncology and Palliative MedicineNordland Hospital TrustBodøNorway
  3. 3.Department of Clinical Medicine, Faculty of Health SciencesUiT—The Arctic University of NorwayTromsøNorway

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