Are endometrial cancer radiotherapy results age related?

Rovirosa, Á.; Cortes, K.; Ascaso, Carlos; Glickman, Ariel; Valdés, Sergio; Herreros, Antonio Garcı́a de; Sánchez, Javier; Zhang, Y.; Li, Y.; Sabater, S.; Arenas, Meritxell; Torné, Aureli

doi:10.1007/s12094-018-1872-x

Cited by 11 publications

(9 citation statements)

References 24 publications

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“…A course of curative radiotherapy may last for six to eight weeks and may potentially affect an older patient’s quality of life (QOL) because of their limited mobility [11,12]. Those issues need to be addressed to provide potential solutions which may improve quality of care for older cancer patients, such as hypofractionated and stereotactic body radiation [6,13,14].…”

Section: Introductionmentioning

confidence: 99%

Challenges Facing Radiation Oncologists in The Management of Older Cancer Patients: Consensus of The International Geriatric Radiotherapy Group

Popescu

Karlsson²,

Vinh-Hung

et al. 2019

Cancers

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The management of older cancer patients remains difficult because of data paucity. Radiation oncologists need to identify potential issues which could affect treatment of those patients. A workshop was organized in Barcelona among international radiation oncologists with special interest in the management of older cancer patients on April 22, 2018. The following consensus was reached: 1. Older cancer patients often faced unconscious discriminating bias from cancer specialists and institutions because of their chronological age. 2. Advances in radiotherapy techniques have allowed patients with multiple co-morbidities precluding surgery or systemic therapy to achieve potential cure in early disease stages. 3. The lack of biomarkers for frailty remains an impediment to future research. 4. Access to healthcare insurance and daily transportation remains an issue in many countries; 5. Hypofractionation, brachytherapy, or stereotactic techniques may be ideally suited for older cancer patients to minimize transportation issues and to improve tolerance to radiotherapy. 6. Patients with locally advanced disease who are mentally and physically fit should receive combined therapy for potential cure. 7. The role of systemic therapy alone or combined with radiotherapy for frail patients needs to be defined in future clinical trials because of targeted agents or immunotherapy may be less toxic compared to conventional chemotherapy.

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Section: Introductionmentioning

confidence: 99%

Challenges Facing Radiation Oncologists in The Management of Older Cancer Patients: Consensus of The International Geriatric Radiotherapy Group

Popescu

Karlsson²,

Vinh-Hung

et al. 2019

Cancers

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“…Radiotherapy is most commonly used as adjuvant therapy for intermediate- to high-risk carcinomas. 45 Chemotherapy is used as postoperative treatment for high-risk stage I and II disease, stage III and IV disease or as primary treatment for unresectable advanced, metastatic, or recurrent disease. 5 The combination of carboplatin and paclitaxel is considered first- line chemotherapy.…”

Section: Adjuvant Treatmentmentioning

confidence: 99%

Surgical treatment and fertility perservation in endometrial cancer

Kovačević

2021

Radiology and Oncology

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BackgroundEndometrial cancer (EC) represents a high health burden in Slovenia and worldwide. The incidence is increasing due to lifestyle and behavioural risk factors such as obesity, smoking, oestrogen exposure and aging of the population. In many cases, endometrial cancer is diagnosed at an early stage due to obvious signs and symptoms. The standard treatment is surgery with or without adjuvant therapy, depending on the stage of the disease and the risk of recurrence. However, treatment modalities have changed in the last decades, considerably in the extent of lymphadenectomy.ConclusionsThe gold standard of treatment for is surgery, which may be the only treatment modality in the early stages of low-grade tumours. In recent years, a minimally invasive approach with sentinel node biopsy (SNB) has been proposed. A conservative approach with hormonal treatment is used if fertility preservation is desired. If EC is in advance stage, high-risk histology, or high grade, radiotherapy, chemotherapy, or a combination of both is recommended.

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“…Endometrial cancer is the most common gynecologic cancer, and it is frequently diagnosed in elderly patients 1. Nearly two-thirds of patients with endometrial cancer in developed countries are over 65 years old at the time of diagnosis, and the incidence is rising as life expectancy increases worldwide 2 3. Several studies have shown that older age is an indicator of a poor prognosis in patients with endometrial cancer 4 5.…”

Section: Introductionmentioning

confidence: 99%

“…Radiotherapy is well tolerated by elderly patients with endometrial cancer, with more than 90% of patients completing their treatments 11 12. However, the treatment and toxicity outcomes of elder patients with endometrial cancer treated with adjuvant radiotherapy has been rarely evaluated 3 13. A few reports have described an increase in radiotherapy complications, while others have indicated that the incidence of complications among older populations is comparable to that of younger populations 3 13…”

Section: Introductionmentioning

confidence: 99%

Multi-institutional study on the role of post-operative radiotherapy in elderly patients with endometrial cancer

Yavaş

Güler

Gültekin

et al. 2023

International Journal of Gynecological Cancer

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ObjectiveTo investigate the prognostic factors for survival and toxicities in elderly (≥65 years) patients with endometrial cancer who underwent post-operative radiotherapy. Additionally, to compare the treatment outcomes between the older elderly (≥75 years) and younger elderly (65–74 years) patients.MethodsMedical records of patients with enometrial cancer treated between January 1998 and July 2019 were reviewed. Patients with stage IA to IIIC2, all histology subtypes, and any grade were included. All patients underwent total abdominal hysterectomy and received adjuvant radiotherapy with or without chemotherapy. All but 67 (8.4%) of 801 patients had lymph node dissection. Clinicopathological factors and treatment strategies were compared between the two age groups. The prognostic factors for overall survival and progression-free survival were investigated.ResultsA total of 801 patients with enometrial cancer, 627 patients (78.3%) younger elderly and 174 patients (21.7%) in the older elderly group were included. Median follow-up was 74.3 months (range 0.4–224.6). The older elderly patients had significantly higher rates of grade 3 tumors (51.7% vs 40.8%; p=0.04), cervical glandular involvement (21.8% vs 14.0%; p=0.03), and cervical stromal invasion (34.5% vs 27.9%; p=0.04) than the younger elderly patients. The rates of lymph node dissection (p=0.2), radiotherapy modalities (p=0.92), and systemic chemotherapy (p=0.2) did not differ between the two groups. The 5-year locoregional control and distant metastasis rates were 88.3% and 23.8%, respectively. The 5-year cause-specific survival and progression-free survival rates for younger and older elderly patients, were 79.8% vs 74.3% (p=0.04) and 67.5% vs 57.8% (p<0.001), respectively. In multivariate analysis, larger tumor size, non-endometrioid histology, cervical stromal involvement, and stage III disease were associated with poor cause-specific survival and progression-free survival. Age was an independent predictor of worse progression-free survival, but not of cause-specific survival. There was no significant difference in acute and late gastrointestinal and genitourinary toxicities between age groups.ConclusionsPost-operative radiotherapy for elderly patients with endometrial cancer is effective and well tolerated. Advanced age should not preclude appropriate treatment, especially in those with adequate quality of life, life expectancy, and functional status.

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Are endometrial cancer radiotherapy results age related?

Cited by 11 publications

References 24 publications

Challenges Facing Radiation Oncologists in The Management of Older Cancer Patients: Consensus of The International Geriatric Radiotherapy Group

Challenges Facing Radiation Oncologists in The Management of Older Cancer Patients: Consensus of The International Geriatric Radiotherapy Group

Surgical treatment and fertility perservation in endometrial cancer

Multi-institutional study on the role of post-operative radiotherapy in elderly patients with endometrial cancer

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