Age Is Not a Limiting Factor in Interventional Radiotherapy (Brachytherapy) for Patients with Localized Cancer

Abstract

This review examines the role of interventional radiotherapy (IRT otherwise known as brachytherapy) in cancer treatment for elderly patients. Despite their advanced age and associated comorbidities, elderly patients should receive definitive cancer therapies, including surgery and radiotherapy (RT). In fact, RT becomes first-line option for patients who are not eligible for surgery (due to comorbidities, anticoagulant drugs, and risk of disfigurement) or those who refuse it. It emerged from this review of the literature as effective, simple, safe, and comfortable and was associated with good local control, low toxicity rates, and excellent cosmesis and provided a cost benefit. IRT may be used as sole treatment for small cancers or as a useful adjunct to surgery or external beam radiotherapy (EBRT) in more advanced (or lymph node positive) cases, especially when the aim is local control with adequate preservation of normal tissue function. As palliative treatment, IRT preserves quality of life and/or improves survival. It is to be hoped that this review will serve as a helpful guide for members of multidisciplinary teams that are involved in treating elderly patients with cancer.

Radiotherapy in Periocular Cutaneous Malignancies: A Retrospective Study

“…A review article on brachytherapy in nonmelanoma skin cancer of the eyelid concluded that brachytherapy provides high clinical efficacy (median local control rate 95.2%) and good functional-cosmetic outcome (median 100%) [34]. In addition, especially in old and frail patients, brachytherapy is a safe treatment modality [35]. …”

Precision Medicine and the Role of Biomarkers of Radiotherapy Response in Breast Cancer

“…APBI allows the delivery of higher radiation doses in the area of the tumor bed whilst reducing the dose received by normal breast tissue and adjacent organs at risk. Shorter treatment times and acceptable acute toxicity rates can improve patient quality of life whilst also reducing the total cost of treatment (10)(11)(12)(13)(14). Linear accelerators are the most commonly used devices for delivering external beam radiation to patients.…”

Can brachytherapy be properly considered in the clinical practice? Trilogy project: The vision of the AIRO (Italian Association of Radiotherapy and Clinical Oncology) Interventional Radiotherapy study group

“…Brachytherapy (BT, interventional radiotherapy -IRT) is a kind of radiation therapy, in which the radioactive source is placed nearby or even inside the cancer itself; BT may be used alone or in combination with other thera-peutic strategies such as external beam radiation therapy, surgery, or chemotherapy. It may represent a valid alternative to surgery in some circumstances [1] or a necessary complementary step to surgery in other situations [2], therefore it plays a pivotal role in several anatomical areas, or in specific patients who may benefit from the method in a balance between risks and benefits, such as elderly or frail patients [3,4].…”