ecancermedicalscience

Clinical Study

How well do elderly patients with cervical cancer tolerate definitive radiochemotherapy using RapidArc? Results from an institutional audit comparing elderly versus younger patients

20 Nov 2014
Santam Chakraborty, M Geetha, Sampada Dessai, Vijay M Patil

Purpose: Elderly patients (65 or older) with cervical cancer often receive suboptimal radio-chemotherapy. Intensity-modulated radiotherapy (IMRT) may improve tolerance to treatment in this setting. This study was designed to compare the treatment-related toxicities and compliance with treatment in patients of cervical cancer treated definitively with RapidArc IMRT in our institute.

Methods and materials: The treatment records of all patients treated with RapidArc IMRT between April 2012 and April 2014 were reviewed, retrospectively. Prospectively collected data regarding treatment toxicity (CTCAE 4.0), treatment outcomes and parameters related to treatment compliance were compared amongst two age groups (< 65 and ≥ 65 years). The results of 66 patients were identified, of whom 23 were found to be ≥ 65 years age. All patients completed planned external beam radiotherapy. However, significantly fewer patients in the elderly group received concurrent chemoradiation (98% versus 65%, p < 0.001). Old age (median 75 years, IQR: 74–78 years) was the commonest cause for non-receipt of chemotherapy. Incidence of grade 3 haematological toxicities (26.7% versus 16.7%) and gastrointestinal toxicity (16.7% versus 13.3%) were not significantly different between the two groups. Other treatment-related toxicities, breaks, treatment duration and early outcomes were also not significantly different between the two age groups.

Conclusions: The use of IMRT did not result in excess toxicities in the elderly population and was associated with equivalent compliance to treatment. Concurrent chemoradiation can be safely combined in elderly patients with perfect organ function and performance status.

Related Articles

Association of Medical and Pediatric Oncologists of Kerala (AMPOK)
Amanda Acioli de Almeida Robatto, Erika Andrade Rocha, Renata Colombo Bonadio, Denis Artico Galhera, Carolina Teixeira Muratori, Admir Andre Belo Bueno, Abraão Ferreira Lopes Dornellas, Luciana Bastos Valente Alban, Carolina Ribeiro Victor, Maria Ignez Freitas Melro Braghiroli, Marília Polo Mingueti e Silva, Camila Soares Araujo, Carlos Frederico Sparapan Marques, Caio Sergio Rizkallah Nahas, Karim Yaqub Ibrahim, André Tsin Chih Chen, Paulo Marcelo Gehm Hoff, Camila Motta Venchiarutti Moniz
Adeyemi Adebola Okunowo, Rukayat Omolola Salawu-Giwa, Oluwaseun Emmanuel Familusi, Salimat Abisoye Yusuf-Awesu, Fadekemi Ooreoluwapo Gabriel-Raji
Jeanine Justiniano, Ally H Mwanga, Daniel W Kitua, Nashivai E Kivuyo, Seif Wibonela, Cameron E Gaskill
Joaquin Fernandez-Alberti, Alex R Villaalta López, Guillermo Scolari, Alejandro Iotti, Marcelo Featherston