Very Elderly (>80 Years), Frail Patients with Muscle-invasive Bladder Cancer and Comorbidities: Is Curative Irradiation Feasible?
| Autor: | Nicola Settineri, Corrado Spatola, Giuseppe Privitera, Grazia Acquaviva, Angelo Platania, Manuela Crispi, Stefano Pergolizzi, Anna Santacaterina, Carmela Palazzolo |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Frail Elderly medicine.medical_treatment Urogenital System Comorbidity Disease-Free Survival Medical Records Imaging Three-Dimensional Actuarial Analysis medicine Humans Neoplasm Invasiveness Radiation Injuries Survival analysis Neoplasm Staging Retrospective Studies Aged 80 and over Muscle Neoplasms Bladder cancer business.industry Genitourinary system Medical record Radiotherapy Dosage Retrospective cohort study General Medicine medicine.disease Survival Analysis Surgery Gastrointestinal Tract Radiation therapy Treatment Outcome Urinary Bladder Neoplasms Oncology Ambulatory Feasibility Studies Female Radiotherapy Conformal business 3D conformal radiation therapy Curative conformal irradiation Elderly Frail Medicine (all) |
| Zdroj: | Tumori Journal. 101:609-613 |
| ISSN: | 2038-2529 0300-8916 |
| DOI: | 10.5301/tj.5000361 |
| Popis: | Purpose To evaluate clinical results in elderly and frail patients with bladder cancer treated with curative conformal irradiation alone. Methods The records of ambulatory frail elderly patients, age >80 years, Charlson Comorbidity Index (CCI) >5, with invasive bladder cancer, were retrospectively analyzed. The patients were irradiated with curative intent. Acute and late toxicities were evaluated. Results A total of 27 ambulatory patients were treated. Median age was 84.5 years and a median CCI of 6.5 was recorded. Median delivered radiation dose was 64 Gy. All patients completed the planned treatment. Grade 1-2 gastrointestinal (GI) and genitourinary (GU) toxicities were observed in 55.5% of patients (15/27). At the last follow-up, no late G3+ toxicities have been observed, with G1-2 toxicities reported in 11.1% of patients (3/27). Higher values of CCI were associated with higher acute GU/GI toxicities; there was a correlation between CCI and acute GU toxicity ( r = 0.43, p = 0.027). The mean survival time was 23.5 months (95% confidence interval 20.9-26.1) and no median was reached. Locoregional disease-free events and metastasis-free survival showed a 2-year actuarial rate of 90% and 87%, respectively, with an actuarial 2-year overall survival of 84.5%. Conclusions Our results demonstrate safety and feasibility of curative radiation therapy in very elderly and frail patients with bladder cancer using 3D conformal radiation therapy. |
| Databáze: | OpenAIRE |
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