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Cancers 2019, 11(3), 371; https://doi.org/10.3390/cancers11030371

Challenges Facing Radiation Oncologists in The Management of Older Cancer Patients: Consensus of The International Geriatric Radiotherapy Group

1
Department of Radiation Oncology, Prof. Dr. Ion Chricuta Oncology Institute, Cluj-Napoca 400015, Romania
2
Department of Radiation Oncology, International Geriatric Radiotherapy Group, Washington, DC 20001, USA
3
Department of Radiation Oncology, University Hospital of Martinique, Martinique 97200, France
4
Department of Radiation Oncology, Instituto Portugues de Oncologia Francisco Martins Porto E.P.E, Porto 4200-072, Portugal
5
Department of Radiation Oncology, Baclesse Cancer Center, Caen 14000, France
6
Department of Radiation Oncology, McGill University, Montreal H3T 1E2, Canada
7
Department of Radiation Oncology, University of Bonn, Bonn 43217, Germany
8
Department of Radiation Oncology, Humanitas Gavazzeni Bergamo, Bergamo 24125, Italy
9
Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
10
Department of Radiation Oncology, Arnau de Vilanova University Hospital, Lleida 25198, Spain
11
Department of Radiation Oncology, Clattterbridge Cancer Center, Liverpool CH63 4JY, UK
12
Department of Radiation Oncology, Fernando Pessoa Canarias Las Palmas University, Las Palmas 35010, Spain
13
Department of Radiation Oncology, Howard University, Washington, DC 20060, USA
14
Department of Radiation Oncology, Sant Joan de Reus University, University Rovira i Virgili, Tarragona 43204, Spain
*
Author to whom correspondence should be addressed.
Received: 6 February 2019 / Revised: 2 March 2019 / Accepted: 8 March 2019 / Published: 16 March 2019
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Abstract

The management of older cancer patients remains difficult because of data paucity. Radiation oncologists need to identify potential issues which could affect treatment of those patients. A workshop was organized in Barcelona among international radiation oncologists with special interest in the management of older cancer patients on April 22, 2018. The following consensus was reached: 1. Older cancer patients often faced unconscious discriminating bias from cancer specialists and institutions because of their chronological age. 2. Advances in radiotherapy techniques have allowed patients with multiple co-morbidities precluding surgery or systemic therapy to achieve potential cure in early disease stages. 3. The lack of biomarkers for frailty remains an impediment to future research. 4. Access to healthcare insurance and daily transportation remains an issue in many countries; 5. Hypofractionation, brachytherapy, or stereotactic techniques may be ideally suited for older cancer patients to minimize transportation issues and to improve tolerance to radiotherapy. 6. Patients with locally advanced disease who are mentally and physically fit should receive combined therapy for potential cure. 7. The role of systemic therapy alone or combined with radiotherapy for frail patients needs to be defined in future clinical trials because of targeted agents or immunotherapy may be less toxic compared to conventional chemotherapy. View Full-Text
Keywords: older; discrimination; frailty; comorbidity; radiotherapy tolerance older; discrimination; frailty; comorbidity; radiotherapy tolerance
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Popescu, T.; Karlsson, U.; Vinh-Hung, V.; Trigo, L.; Thariat, J.; Vuong, T.; Baumert, B.G.; Motta, M.; Zamagni, A.; Bonet, M.; Myint, A.S.; Lara, P.C.; Nguyen, N.P.; Arenas, M. Challenges Facing Radiation Oncologists in The Management of Older Cancer Patients: Consensus of The International Geriatric Radiotherapy Group. Cancers 2019, 11, 371.

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