Radiation therapy for cervical cancer in the elderly

Objective. To evaluate the long-term results of radical radiation therapy (RT) for cervical cancer in elderly patients. Methods. We reviewed the clinical records of 727 patients with cervical cancer who underwent radical RT at the Tokushima University Hospital and compared the treatment results of three age groups: <= 64 years (younger group [YG], 337 patients), 65-74 years (young-old group [YOG], 258 patients), and >= 75 years (older group [OG], 132 patients). Results. At the last follow-up, 155 YG (46%), 77 YOG (30%), and 48 OG patients (36%) had died of cervical cancer; the median follow-up periods were 82, 87, and 68 months, respectively. The 5-/10-year disease-specific survival rates were 60%/52% in YG, 76%/68% in YOG, and 66%/57% in OG. Differences between OG and the other groups were not significant. The 5-/10-year disease-specific survival rate of YOG was significantly superior to that of YG (p < 0.001). Clinical stage was the only significant prognostic variable (p < 0.001). Late radiation morbidity of grades 2-4 in the bladder and/or rectum occurred in 22% of YG, 31% of YOG, and 8% of OG patients. Conclusions. RT was well tolerated in elderly patients, and age was not a significant prognostic factor. In the management of cervical cancer, advanced age is not a contraindication to radical RT. (c) 2007 Elsevier Inc. All rights reserved.