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    New horizons in radiotherapy for older people

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    Authors
    Cree, Anthea
    O'Donovan, A
    O'Hanlon, S
    Affiliation
    The Christie NHS Foundation Trust, Manchester, UK
    Issue Date
    2019
    
    Metadata
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    Abstract
    Radiotherapy is an effective, albeit underutilised, treatment for cancer in older adults, especially for those who are surgically inoperable or for whom chemotherapy poses too great a risk. It is estimated that approximately half of patients with cancer could benefit from radiotherapeutic management. This article synthesises the basics of how radiotherapy works, recent developments in the field and considers how this treatment modality may be adapted in an older patient population or may evolve in the future. Technological advances of relevance include Intensity Modulated Radiotherapy (IMRT), Volumetric Modulated Arc therapy (VMAT), Stereotactic Ablative Body Radiotherapy (SABR), proton therapy, MR guided radiotherapy, as well as better image guidance during irradiation in order to improve precision and accuracy. New approaches for better integration of geriatric medicine principles into the oncologic assessment and workup will also be considered, in order to provide more age attuned care. For more informed decision making, a baseline assessment of older radiotherapy patients should encompass some form of Comprehensive Geriatric Assessment. This can facilitate the optimal radiotherapy regime to be selected, to avoid overly toxic regimes in patients with frailty. The review discusses how these new initiatives and technologies have potential for effective oncologic management and can help to reduce the toxicity of treatment for older adults. It concludes by highlighting the need for more evidence in this patient population including better patient selection and support for treatment to enhance person-centred care.
    Citation
    Cree A, O'Donovan A, O'Hanlon S. New horizons in radiotherapy for older people. Age Ageing. 2019 Jul 30.
    Journal
    Age and ageing
    URI
    http://hdl.handle.net/10541/622089
    DOI
    10.1093/ageing/afz089
    PubMed ID
    31361801
    Additional Links
    https://dx.doi.org/10.1093/ageing/afz089
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1093/ageing/afz089
    Scopus Count
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    All Christie Publications

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