Outcome of cervical cancer in extremely elderly patients receiving radiation therapy

Shin, Hae Rim; Kim, Sang Heon; Kim, Beob Jong; Kim, Moon Hong; Choi, Seok Cheol; Ryu, Sang Young; Lee, Eui Don; Lee, Kyung Hee

Abstract

OBJECTIVE
The aim of this study was to evaluate the tolerance and outcome of elderly cervical cancer patients who were treated with radiation therapy retrospectively.
METHODS
Fourteen patients over 80 years with pathologically proven stage I-IV cervical cancer who were treated with definitive RT between 1993 and 2003 were analyzed. We investigated response rates, recurrence rates, complications, progression free intervals, and current status of subjects.
RESULTS
The age of the 14 patients ranged from 80 to 88 (median age: 81). The distribution of clinical stage by FIGO classification were > or =stage IIB (78.6%). The most common histologic type was squamous cell carcinoma. Nine patients (64.3%) underwent definitive radiation therapy. Among the 9 patients who had undergone radiotherapy, 7 patients (77.8%) showed complete response. One patient underwent surgical intervention followed by chemotherapy due to progression of disease despite radiotherapy. Two patients experienced radiation cystitis and 1 patient suffered from radiation colitis, however, other patients did not manifestate significant complications. One patient who underwent palliative chemotherapy due to persistent disease experienced mild marrow suppression and neurologic symptoms temporarily.
CONCLUSION
The elderly patients over 80 years with good performance status may tolerate definitive pelvic radiation administered according to conventional fractionation schedules to control cervical cancer. Definitive radiation therapy with or without concurrent chemotherapy should not be excluded as a treatment option even for patients older than 80 years.