Radiation therapy for cervical cancer in the elderly

Gynecol Oncol. 2007 Nov;107(2):339-43. doi: 10.1016/j.ygyno.2007.07.058. Epub 2007 Aug 16.

Abstract

Objective: To evaluate the long-term results of radical radiation therapy (RT) for cervical cancer in elderly patients.

Methods: We reviewed the clinical records of 727 patients with cervical cancer who underwent radical RT at the Tokushima University Hospital and compared the treatment results of three age groups: </=64 years (younger group [YG], 337 patients), 65-74 years (young-old group [YOG], 258 patients), and >/=75 years (older group [OG], 132 patients).

Results: At the last follow-up, 155 YG (46%), 77 YOG (30%), and 48 OG patients (36%) had died of cervical cancer; the median follow-up periods were 82, 87, and 68 months, respectively. The 5-/10-year disease-specific survival rates were 60%/52% in YG, 76%/68% in YOG, and 66%/57% in OG. Differences between OG and the other groups were not significant. The 5-/10-year disease-specific survival rate of YOG was significantly superior to that of YG (p<0.001). Clinical stage was the only significant prognostic variable (p<0.001). Late radiation morbidity of grades 2-4 in the bladder and/or rectum occurred in 22% of YG, 31% of YOG, and 8% of OG patients.

Conclusions: RT was well tolerated in elderly patients, and age was not a significant prognostic factor. In the management of cervical cancer, advanced age is not a contraindication to radical RT.

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / pathology
  • Adenocarcinoma / radiotherapy*
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Brachytherapy / adverse effects
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / radiotherapy*
  • Chemotherapy, Adjuvant
  • Disease-Free Survival
  • Female
  • Humans
  • Japan / epidemiology
  • Medical Records
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Staging
  • Prognosis
  • Radiation Injuries / etiology*
  • Radiotherapy / adverse effects
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
  • Uterine Cervical Neoplasms / mortality
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / radiotherapy*