Cancer in Patients Aged 90 Years or Older: Radiation Therapy

Mitsuhashi, Norio; Hayakawa, Kazushige; Yamakawa, Michitaka; Sakurai, Hideyuki; Saito, Yoshihiro; Hasegawa, Masahiro; Akimoto, Tetsuo; Niibe, Hideo

doi:10.1148/radiology.211.3.r99jn21829

Cited by 53 publications

(31 citation statements)

References 18 publications

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“…Previous studies have found that palliative RT provides effective symptom management and produces little to no toxicity in elderly patients, including those >90 years of age (36)(37)(38)(39)(40)(41)(42)51). Similar results have been found for lung and breast cancer patients receiving curative RT (8,52,53).…”

Section: Discussionsupporting

confidence: 66%

“…There is a need to identify the potential limitations and hazards of palliative RT in the elderly (4,11). Alternatively, some studies have shown that palliative RT provides effective pain management in elderly patients with minimal toxicity in a variety of site groups (36)(37)(38)(39)(40)(41)(42). Consequently, educating physicians on the benefits of palliative RT is recommended to provide equal access to RT for patients of all ages (18).…”

Section: Introductionmentioning

confidence: 99%

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Elderly Patients With Painful Bone Metastases Should be Offered Palliative Radiotherapy

Campos

Presutti

Zhang

et al. 2010

International Journal of Radiation Oncology*Biology*Physics

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Section: Discussionsupporting

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Elderly Patients With Painful Bone Metastases Should be Offered Palliative Radiotherapy

Campos

Presutti

Zhang

et al. 2010

International Journal of Radiation Oncology*Biology*Physics

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“…However standard protocols and/or doses sometimes need to be modified according to patient's conditions or to the onset of complications [65]. As for surgery, age per se does not represent a limiting factor to the prescription of RT [66,67]. …”

Section: Cancer Therapy In the Elderlymentioning

confidence: 99%

Aging, cancer, and cancer vaccines

et al. 2012

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World population has experienced continuous growth since 1400 A.D. Current projections show a continued increase - but a steady decline in the population growth rate - with the number expected to reach between 8 and 10.5 billion people within 40 years. The elderly population is rapidly rising: in 1950 there were 205 million people aged 60 or older, while in 2000 there were 606 million. By 2050, the global population aged 60 or over is projected to expand by more than three times, reaching nearly 2 billion people [1]. Most cancers are age-related diseases: in the US, 50% of all malignancies occur in people aged 65-95. 60% of all cancers are expected to be diagnosed in elderly patients by 2020 [2]. Further, cancer-related mortality increases with age: 70% of all malignancy-related deaths are registered in people aged 65 years or older [3]. Here we introduce the microscopic aspects of aging, the pro-inflammatory phenotype of the elderly, and the changes related to immunosenescence. Then we deal with cancer disease and its development, the difficulty of treatment administration in the geriatric population, and the importance of a comprehensive geriatric assessment. Finally, we aim to analyze the complex interactions of aging with cancer and cancer vaccinology, and the importance of this last approach as a complementary therapy to different levels of prevention and treatment. Cancer vaccines, in fact, should at present be recommended in association to a stronger cancer prevention and conventional therapies (surgery, chemotherapy, radiation therapy), both for curative and palliative intent, in order to reduce morbidity and mortality associated to cancer progression.

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“…The treatment of choice should be based on a medical assessment and the preferences of the patient, not on chronological age alone [18] . not be considered a contraindicator for radiation therapy [24][25][26][27][28] . Nevertheless, it has been reported more than a decade ago that elderly patients with HNC recruited in clinical trials had a better performance status compared to those who were not included in clinical trials; therefore, the results from clinical trials might be biased and not generalizable to the general aged HNC population [29] .…”

Section: General Principlesmentioning

confidence: 99%

Optimal management of the elderly patient with head and neck cancer: Issues regarding surgery, irradiation and chemotherapy

Mountzios¹

2015

WJCO

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Head and neck cancer (HNC) represents the sixth most common malignancy and accounts for approximately 6% of new cancer cases annually worldwide. As life expectancy constantly increases, the onset of HNC in patients older than 65 years of age at diagnosis is not rare and up to one fourth of cases occurs in patients older that 70 years at age. Because elderly cancer patients are severely under-represented in clinical trials, there is a clear need to address the particular aspects of this specific patient group, especially in the context of novel multidisciplinary therapeutic approaches. The frailty of elderly patients with HNC is attributed to the high incidence of smoking and alcohol abuse in this malignancy and the presence of substantial cardiovascular, respiratory or metabolic comorbidities. In the current work, I provide an overview of current and emerging treatment approaches, in elderly patients with HNC. In particular, I discuss modern surgical approaches that improve radical excision rates while preserving functionality, the incorporation of modern radiotherapeutic techniques and the introduction of novel chemotherapeutic combinations and molecular targeted agents in an effort to reduce toxicity without compromising efficacy. Finally, there is an urgent need to increase accrual and active participation of elderly patients with HNC in clinical trials, including biomarker evaluation in biopsy specimens towards an individualized therapeutic approach.

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Cancer in Patients Aged 90 Years or Older: Radiation Therapy

Abstract: Age of 90 years or older is not a limiting factor for radiation therapy.

Cited by 53 publications

References 18 publications

Elderly Patients With Painful Bone Metastases Should be Offered Palliative Radiotherapy

Elderly Patients With Painful Bone Metastases Should be Offered Palliative Radiotherapy

Aging, cancer, and cancer vaccines

Optimal management of the elderly patient with head and neck cancer: Issues regarding surgery, irradiation and chemotherapy

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