G8 score predicts survival in elderly women undergoing vaginal brachytherapy: A retrospective cohort study

With increasing life expectancy, cancer incidence in the elderly is rising. Elderly patients often have comorbidities and social limitations that require supportive care for safe treatment. Brachytherapy is a practical radiotherapy modality for elderly gynecologic cancer patients. This study aimed to assess the prognostic value of the G8 screening tool in women aged ≥ 60 receiving vaginal brachytherapy for cervix or endometrium carcinoma.

Fifty-five patients treated between 2020 and 2024 were retrospectively evaluated. G8 scores were collected at baseline and categorized as ≤ 14 (frail) and > 14 (non-frail). The correlation of G8 scores with clinical features and survival outcomes were statistically analyzed.

Patients with G8 scores > 14 had significantly better overall survival (OS: 46.9 ± 1.6 vs. 38.5 ± 3.3 months, p = 0.04) and progression-free survival (PFS: 47.1 ± 1.6 vs. 35.1 ± 3.5 months, p = 0.019). A G8 score > 14 was significantly associated with higher Karnofsky Performance Status ≥ 60 (p = 0.009), and fewer distant metastasis (p = 0.025). No significant differences were found in pathology, FIGO stage or EBRT administration between frail and non-frail groups.

The G8 screening tool is a simple and practical instrument for assessing vulnerability in elderly patients undergoing surgery and adjuvant vaginal brachytherapy for gynecological cancers. Low G8 scores were associated with poorer survival, worse functional status, and higher risk of distant metastasis, independent of tumor factors. These findings suggest that the G8 may have prognostic significance in this population; however, they remain hypothesis-generating and require prospective validation before the G8 can be recommended for guiding clinical decision-making.