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Palliative Radiation Therapy in Older Adults With Cancer: Age-Related Considerations
1Applied Radiation Therapy Trinity (ARTT) research group, Discipline of Radiation Therapy, School of Medicine, Trinity College, Dublin, Ireland.
Clinical Oncology (Royal College of Radiologists (Great Britain))
|July 10, 2020
Summary
Assessing frailty in older cancer patients is crucial for personalized palliative care. Tailoring radiation therapy and using Comprehensive Geriatric Assessment (CGA) can improve quality of life and treatment outcomes.
Area of Science:
- Geriatric Oncology
- Palliative Care
- Radiation Oncology
Background:
- Older adults with cancer present unique challenges in palliative care.
- Radiation therapy use in older adults is inconsistent, with both underutilization and unnecessary treatment observed.
- Physiological reserve capacity, or frailty, is a key factor in determining appropriate cancer treatment for older individuals.
Purpose of the Study:
- To highlight the importance of frailty assessment in older cancer patients.
- To advocate for a two-step approach involving screening and Comprehensive Geriatric Assessment (CGA).
- To discuss adaptations in radiation therapy to better suit older patients and improve quality of life.
Main Methods:
- Appraisal of physiological reserve capacity (frailty assessment).
- Implementation of a two-step approach: initial screening followed by Comprehensive Geriatric Assessment (CGA) when indicated.
- Adaptation of radiotherapy regimens, including shorter courses, single fractions, or hypofractionation, and consideration of patient support needs.
Main Results:
- Frailty assessment identifies patients who may require tailored treatment approaches beyond standard protocols.
- Comprehensive Geriatric Assessment (CGA) can optimize care, potentially reverse or slow frailty progression, and improve quality of life.
- Adapted radiotherapy, considering patient circumstances and reducing treatment burden, can enhance care delivery.
Conclusions:
- Frailty assessment and Comprehensive Geriatric Assessment (CGA) are essential for rational treatment decisions in older cancer patients, particularly in palliative care.
- Personalized radiation therapy adaptations are necessary to accommodate the unique needs and circumstances of older individuals.
- Future radiation oncology professionals require enhanced education in geriatric medicine to effectively manage the aging cancer population.
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