[Radiotherapy of aged cancer patients]

Although it is not a categorized modality, cancers of aged patients, generally characterized by a slow growth, histologically high differentiation and low radiosensitivity due to co-existing chronic anemia, should have more individualized treatment because there is a wide spectrum of differences in functional reservoir and tolerance dose of each organs and individuals. In aged cervical cancer of the uterus, we decrease the fractionated and total irradiation dose of a whole pelvic cavity by 10%. For patients more than 80 years old, we principally abandon external beam and singularly chose an intracavitary treatment. In our protocol, there could find no significant difference in 5 year survival between 51-70 y.o. 51.9% (120/231) and 71-80 y.o. 57% (61/107), but in the over 80 y.o. group, it was decreased to 13.6% (3/22) by increased death of other diseases 61.9% (13/21) compared with 18.4% (36/195) in 51-80 y.o. In radiotherapy of advanced lung cancer in aged, we decreased fractionated and total dose by 10 to 20% with minimum irradiation field. In non-small cell carcinoma, a median survival time was 11.5 months in both over and under 70 y.o., although the response rate (CR + PR) was resulted relatively low in aged, 33.3% (N = 45), compared with under 70 y.o., 38.4 (N = 146). The degrees of impairment in respiratory and bone marrow function were similar in both groups. Accordingly, we convinced the efficacy and the necessity of individualized radiotherapy for aged cancer patients.