Radiotherapy in nonagenarian patients: A 20-year retrospective analysis in a single ternary centre

IntroductionThe global burden of cancer and the ageing population is increasing, resulting in an increase in cancer incidence among elderly patients. This study aimed to evaluate the clinical outcomes and safety profile of radiotherapy in nonagenarians and to contribute to the existing knowledge on radiotherapy in elderly patients.MethodsThis retrospective analysis included nonagenarian patients who received external beam radiotherapy at a single centre in Japan between May 2003 and May 2023. Data, including patient demographics, tumour characteristics, treatment details, and clinical outcomes, were collected from medical records. Statistical analyses including survival and subgroup analyses were performed to summarize the data.ResultsThe analysis included 124 nonagenarian patients who received 151 treatment courses. Among the patients with a median age of 92 years (range, 90-98 years), 71 received palliative-intent radiotherapy and 53 underwent curative-intent radiotherapy. The overall survival rates at 1 and 3 years after radiotherapy were 55.4% and 38.3%, respectively. Performance status and radiotherapy at the primary site were independent prognosis factors for improved overall survival, while age was not. The incidence rate of grades 3-5 radiation-related toxicities was 3.4%, which is generally considered to be acceptable.ConclusionThis study demonstrates that radiotherapy can be effectively and safely used in this age group, supporting its use as a treatment option for both palliative and curative goals. These results contribute to the existing body of evidence on radiotherapy in elderly patients and can guide clinical decision-making in the management of nonagenarian patients with cancer.