Management of The Elderly Cancer Patients Complexity: The Radiation Oncology Potential

Abstract

Radiation oncology has the potential to be an excellent option for the frail elderly cancer patients because of its limited systemic toxicities. It can be effective for curative, prophylactic, disease control or palliative purposes. Currently about 60% of all cancer patients undergoing active treatment at some point receive radiation treatment. However, though widely used, there are limited clinical trials strictly designed for the elderly. This paper will review the key points in the assessment and treatment of elderly cancer patient including quality of life, active life expectancy, cognitive performance, frailty, sarcopenia and how the new technologies can help to reach the key goal of maintaining autonomy and independence for the elderly cancer patient.

Keywords: radiation oncology; cancer; complexity; elderly; frailty; personalized treatment; quality of life; sarcopenia.

Figure 1.

Comparison between successful aging, organ failure, fragility, cancer.

Figure 2.

Flow Chart: Decision making in radiation oncology on elderly cancer patients. For supportive care we mean those cares focuse on preventing and treating symptoms or any complication due to cancer or therapies, during oncological treatment. For palliative care we mean a multidisciplinary approach dedicated to patients with life-threatening illness no longer treatable for cancer, that prevent and relief physical, psychosocial and spiritual sufferings.