Researchers have recommended that palliative radiotherapy be considered for elderly persons with cancer and painful bone metastases after their study showed that these patients demonstrated a meaningful response to this treatment without a reduction in quality of life (QoL).
Palliative treatments may result in lesser outcomes for older persons with cancer than for younger patients due to comorbidity and declining performance. Dr. Paulien Westhoff of the radiotherapy department at the University Medical Center Utrecht, Utrecht, the Netherlands, and colleagues evaluated the effect of age on response to radiotherapy and QoL of patients with painful bone metastases in three age groups: cohort A, 32 to 64 years (520 patients); cohort B, 65 to 74 years (410 patients); and cohort C, 75 years and older (227 patients). The three main types of primary tumors among the men and women were breast (39%), lung (25%), and prostate (23%).
As reported at the 2nd Forum of the European Society for Radiotherapy and Oncology (ESTRO), held in Geneva, Switzerland, April 19-23, 2013, elderly patients had worse performance as measured by Karnofsky Performance Score at inclusion. Baseline QoL revealed significantly more impairment in cohort C compared with the younger groups.
During follow-up, the decline in QoL was similar among the three cohorts. Median survival was 35 weeks in the youngest cohort and 27 weeks in each of the other two. Although elderly patients tended to have less of a response to radiotherapy than younger patients, the response was still significant at 67%, compared with 78% in cohort A and 74% in cohort B. Westhoff’s team noted no differences in mean time to response or between treatment arms. In multivariate analysis, only primary tumor and performance score were significantly associated with response. ■