Patient age as a factor in radiotherapy. Data from the patterns of care study

We studied the effect of patient age on treatment decisions related to radiation therapy using data obtained through the Patterns of Care Study. Definitive treatment given for breast cancer (191 patients) and palliative therapy given for a variety of symptoms (784 patients) were investigated using data collected from 49 facilities selected on a random basis to reflect fairly the national practice of radiotherapy. Elderly (aged 70 or older) patients accounted for 28.6% of the palliatively treated patients and 19.5% of the definitively treated breast patients. No correlation was found between patient age and the dose or number of days used in palliative therapy. Older patients were more likely to have the "boost" dose of radiation to the tumor bed delivered through external rather than implant techniques. While statistically significant, this difference is not felt to be clinically important. We conclude that once a patient is selected for a course of radiation therapy, age per se, is not a basis for prejudicial treatment.