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Muscle-invasive Bladder Cancer in the Elderly Patient With a Focus on Hypofractionated Radiotherapy.
1Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK; University of Leeds, Leeds, UK.
Clinical Oncology (Royal College of Radiologists (Great Britain))
|February 22, 2021
Summary
Older patients with muscle-invasive bladder cancer often have comorbidities. Screening tools can guide treatment, with radiotherapy offering options for those unsuitable for radical cystectomy.
Area of Science:
- Geriatric oncology
- Radiation oncology
Background:
- Muscle-invasive bladder cancer (MIBC) predominantly affects older adults.
- Multimorbidity and frailty are common in this demographic, often precluding definitive treatments like radical cystectomy or (chemo)radiotherapy.
- This leads to increased risk of poor survival and significant disease-related morbidity.
Purpose of the Study:
- To evaluate the utility of functional status screening tools in older MIBC patients.
- To identify patients who would benefit from comprehensive geriatric assessment and prehabilitation.
- To explore ultrahypofractionated and short-fractionated palliative radiotherapy as treatment options.
Main Methods:
- Review of functional status screening tools for elderly cancer patients.
- Analysis of treatment outcomes for MIBC patients unsuitable for standard radical treatments.
- Evaluation of ultrahypofractionated and palliative radiotherapy schedules.
Main Results:
- Screening tools can aid in determining appropriate treatment pathways for older MIBC patients.
- Ultrahypofractionated radiotherapy may achieve good local control with acceptable toxicity in selected patients.
- Short fractionated palliative radiotherapy effectively manages symptoms for those unable to tolerate longer treatments.
Conclusions:
- Functional status assessment is crucial for optimizing treatment in older adults with MIBC.
- Geriatric assessment and prehabilitation can improve outcomes for frail patients.
- Radiotherapy, including ultrahypofractionated and palliative schedules, offers viable treatment strategies for elderly patients with MIBC unsuitable for radical therapies.
