Radiotherapy improves QoL among elderly with bone metastases
medwireNews: Radiotherapy can significantly improve the quality of life (QoL) of elderly individuals with cancer that has metastasized to the bone, show study results presented at the 2nd European Society for Radiotherapy and Oncology (ESTRO) Forum in Geneva, Switzerland.
The finding has important implications for clinical practice, the authors told conference attendees.
"Although we knew already that a single fraction of 8 Gy was effective in treating bone pain across the board, we were unsure as to its precise effect in the elderly," said Paulien Westhoff (University Medical Centre Utrecht, the Netherlands) in an associated press release.
"We were pleased to be able to show that this treatment is effective in all age groups," he added.
A total of 1157 patients received 8 or 24 Gy radiotherapy between March 1996 and September 1998. All participants completed questionnaires on pain and QoL before therapy began, then again during regular follow ups. The three most common cancer types among the participants were breast, at 39%, prostate, at 23%, and lung, at 25%.
Significantly more of the elderly patients - aged 75 years and above (group C) - had a low Karnofsky Performance Score at baseline (20-60, where 100 is perfect health and 0 is death) compared with the younger patients, at 39% versus 26% for those aged 32-64 years (group A) and 29% for those aged 65-74 years (group B).
Furthermore, baseline activity levels revealed significantly more impairment among the elderly compared with the younger patients, with scores of 38, 41, and 49 for groups A, B, and C, respectively, where a score of 100 denotes the lowest level of activity.
Despite these results, and a shorter median survival, Westhoff and colleagues observed a significant QoL response (graded according to national standards) to radiotherapy among the older patients compared with their younger counterparts, at 67% versus 78% in group A and 74% in group B.
Only primary tumor type and Karnofsky performance score were significantly associated with response to treatment in multivariate analysis, add the researchers.
"Bone metastases can profoundly disrupt a patient's life, particularly when, as is the case with many elderly, they already have other health problems," said Westhoff. "Strategies for minimising their effect are vital to improving quality of life."
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By Sarah Guy, medwireNews Reporter