PATTERNS OF RADIATION TREATMENT OF ELDERLY PATIENTS WITH PROSTATE-CANCER

Background. The patterns of radiation care of elderly patients with prostate cancer treated with radiation therapy have not been described. As our population ages and screening increases the number of patients diagnosed, this becomes an important issue. Methods. The U.S. national surveys in prostate cancer conducted by the Patterns of Care Study in radiation oncology and the prostate cancer database from the Department of Radiation Oncology of the Fox Chase Cancer Center (Philadelphia, PA) have been used to compare processes and outcomes of conventional radiation treatment with conformal three-dimensional (3D) radiation treatment in elderly patients (older than or equal to 70 years) compared with younger patients. Results. The U.S. national averages for treating elderly patients with prostate cancer with radiation therapy show equivalent outcomes as those achieved by younger patients. These include all parameters of cancer control and treatment-related late morbidity. Studies from the Fox Chase Cancer Center demonstrate a reduction in acute treatment-related symptoms and equal late morbidity associated with conformal 3D-planned treatment as compared with conventional techniques despite an 8% increase in radiation dose. Therefore, radiation treatment should not be withheld from appropriately selected elderly patients with prostate cancer because of concerns about the patient's tolerance of treatment. Conclusion. Radiation therapy is given to patients with prostate cancer without age bias. The results of treatment are similar for elderly and younger patients. The advantages of the conformal 3D radiation technique is apparent for elderly and younger patients in whom acute symptoms are reduced compared with those produced by the conventional radiation technique.