Review of current best practice and priorities for research in radiation oncology for elderly patients with cancer: the International Society of Geriatric Oncology (SIOG) task force

Kunkler, Ian; Audisio, Riccardo A.; Belkacémi, Yazid; Betz, Michael; Gore, Elizabeth; Hoffe, Sarah E.; Kirova, Youlia; Koper, P.; Lagrange, J. L.; Markouizou, Athina; Pfeffer, Raphael; Villà, Salvador

doi:10.1093/annonc/mdu104

Cited by 103 publications

(49 citation statements)

References 84 publications

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“…85 Readers are referred to a review on best practices in radiation oncology for older adults with cancer by SIOG. 86 OUR RECOMMENDED APPROACH All oncologists should strive to include some form of geriatric assessment in their everyday clinical practice (Table 3). We believe that it is not only feasible, but necessary to provide older patients with high-quality cancer care.…”

Section: Geriatric Assessment For Radiation and Surgical Oncologymentioning

confidence: 99%

What Every Oncologist Should Know About Geriatric Assessment for Older Patients With Cancer: Young International Society of Geriatric Oncology Position Paper

Loh

Soto‐Pérez‐de‐Celis

Hsu

et al. 2018

JOP

137

105

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Aging is a heterogeneous process. Most newly diagnosed cancers occur in older adults, and it is important to understand a patient's underlying health status when making treatment decisions. A geriatric assessment provides a detailed evaluation of medical, psychosocial, and functional problems in older patients with cancer. Specifically, it can identify areas of vulnerability, predict survival and toxicity, assist in clinical treatment decisions, and guide interventions in routine oncology practice; however, the uptake is hampered by limitations in both time and resources, as well as by a lack of expert interpretation. In this review, we describe the utility of geriatric assessment by using an illustrative case and provide a practical approach to geriatric assessment in oncology. CASE J.K. is a 73-year-old man who presented to his primary care physician complaining of bright red blood per rectum. He has a medical history of coronary artery disease, hypertension, hyperlipidemia, and cerebrovascular disease. He is on aspirin, lisinopril, metoprolol, and atorvastatin. A subsequent colonoscopy revealed a 3-cm mass in his descending colon. Biopsy of the mass showed invasive adenocarcinoma. He underwent computed tomography scans of the chest, abdomen, and pelvis, which showed no evidence of metastases. A laparoscopic colectomy was performed, and his cancer was staged as T2N2 (stage III) and microsatellite stable. He is referred to you to discuss adjuvant chemotherapy.

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Section: Geriatric Assessment For Radiation and Surgical Oncologymentioning

confidence: 99%

What Every Oncologist Should Know About Geriatric Assessment for Older Patients With Cancer: Young International Society of Geriatric Oncology Position Paper

Loh

Soto‐Pérez‐de‐Celis

Hsu

et al. 2018

JOP

137

105

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“…Kunkler et al 5 reported the results of a task force of the International Society of Geriatric Oncology demonstrating the limited Level I evidence for radiotherapy in the elderly, and provided recommendations for curative treatments but not for the metastatic disease conditions. In general, this report suggests that stereotactic treatments can be a valid approach in several cases.…”

Section: Introductionmentioning

confidence: 99%

The role of stereotactic body radiation therapy (SBRT) in the treatment of oligometastatic disease in the elderly

Scorsetti

Clerici

Navarria

et al. 2015

BJR

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Objective: To report about clinical outcome of stereotactic body radiation therapy (SBRT) in the treatment of oligometastatic disease in elderly patients. Methods: Patients with 1-4 inoperable metastases were treated with SBRT. Dose prescription ranged from 40 to 75 Gy in 3-8 fractions. SBRT was delivered using the volumetric modulated arc therapy technique with flattening filter-free photon beams. The primary end points were in-field local control (LC) and toxicity. Secondary end points were overall survival (OS) and disease-specific survival (DSS). Results: 82 patients with 111 total metastases were treated. Median age was 79 years. 64 patients (78%) had a single lesion; the remaining patients had 2-4 lesions. 16 (14.4%) lesions were localized in the abdomen, 50 (45.0%) in the liver and 45 (40.5%) in the lungs. Local response was observed for 87 lesions (78.4%) while local progression was observed in 24 lesions (21.6%). Actuarial 1-year LC was 86.8% 6 3.3%. Actuarial 1-year OS was 93.6% 6 2.7%. 2-year findings were 76.3% 6 4.4% and 72.0% 6 5.6%, respectively. Actuarial 1-and 2-year DSS results were 97.5% 6 2.0% and 81.6% 6 4.9%, respectively. Treatment-related Grade 2-3 toxicity was observed in five patients (4.2%); Grade 1 toxicity in seven patients (5.9%) and no toxicity was observed in 85.4% of the cases. Conclusion: SBRT is a safe and effective therapeutic option for the treatment of oligometastatic disease in the elderly with acceptable rates of LC and low treatmentrelated toxicity. Advances in knowledge: The use of SBRT for oligometastatic disease in the elderly can be considered as a valuable approach, particularly for patients with fragile status or refusing other approaches.

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“…Adjuvant radiation for breast cancer can also be hypofractionated over 3 weeks or even a single week in small tumors. An excellent review of the available evidence in geriatric oncology was recently published by the SIOG radiation task force [ 25 ].…”

Section: Radiationmentioning

confidence: 99%

Geriatric Oncology

Extermann

Hussain²

2015

Tropical Hemato-Oncology

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Relevance to Tropical AreasAt fi rst glance, geriatric oncology might seem to be a problem limited to developed countries. Yet, as progresses have been made in sanitation, nutrition, and infectious disease prevention and treatment, life expectancy has markedly progressed in tropical countries. For example, the life expectancy at birth is now 65 years or more in 174 of 223 countries listed in the World Factbook, including countries such as India, Bangladesh, the Philippines, Indonesia, Brazil, or Egypt [ 1 ]. In fact in 2000, 59 % of the persons aged 65 and older lived in developing countries, and this proportion is projected to rise to 71 % by 2030 [ 2 ]. With this demographic trend comes an increased prevalence of chronic diseases, cancer being one of them. Therefore, medical teams training and planning for the management of cancer in the elderly will be a crucial component of good cancer care in tropical countries.

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Review of current best practice and priorities for research in radiation oncology for elderly patients with cancer: the International Society of Geriatric Oncology (SIOG) task force

Cited by 103 publications

References 84 publications

What Every Oncologist Should Know About Geriatric Assessment for Older Patients With Cancer: Young International Society of Geriatric Oncology Position Paper

What Every Oncologist Should Know About Geriatric Assessment for Older Patients With Cancer: Young International Society of Geriatric Oncology Position Paper

The role of stereotactic body radiation therapy (SBRT) in the treatment of oligometastatic disease in the elderly

Geriatric Oncology

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