TY - JOUR
T1 - Radiotherapy of pancreatic cancer in older patients
T2 - A systematic review
AU - Ciabatti, Selena
AU - Cammelli, Silvia
AU - Frakulli, Rezarta
AU - Arcelli, Alessandra
AU - Macchia, Gabriella
AU - Deodato, Francesco
AU - Cilla, Savino
AU - Giaccherini, Lucia
AU - Buwenge, Milly
AU - Morganti, Alessio G.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Pancreatic cancer (PaC) will soon be one of the main causes of cancer mortality. Furthermore, its incidence is higher in the older population and radiotherapy (RT) represents a treatment option. The aim of this review was to evaluate feasibility and outcome of RT in older patients with PaC. A systematic literature review of patients aged ≥65 years with PaC treated with RT was performed using the PRISMA methodology. Eleven papers (1830 patients) fulfilled our inclusion criteria and were analyzed. RT was prescribed either alone or as an adjuvant treatment. Prescribed RT dose ranged from 22.0 to 70.0 Gy with conventional fractionation or hypo-fractionated schedule and delivered by three-dimensional conformal RT, intensity modulated RT or stereotactic body RT. Grade ≥ 3 acute and grade ≥ 2 late toxicity rates ranged between 0.0% and 52.6% (median: 0.5%) and between 0.0% and 15.0% (median: 0%), respectively. Median overall survival and two-year survival rate were 11.3 months (range: 6.4–69.0 months) and 49.0% (range 6.6–75.5%), respectively. RT in older patients seems to be tolerable and safe particularly in terms of late toxicity irrespective of the treatment settings. Therefore, RT can represent a treatment option in PaC even in an older population. Further analyses and prospective trials enrolling older patients are needed to better define the risk/benefit ratio in different treatment settings.
AB - Pancreatic cancer (PaC) will soon be one of the main causes of cancer mortality. Furthermore, its incidence is higher in the older population and radiotherapy (RT) represents a treatment option. The aim of this review was to evaluate feasibility and outcome of RT in older patients with PaC. A systematic literature review of patients aged ≥65 years with PaC treated with RT was performed using the PRISMA methodology. Eleven papers (1830 patients) fulfilled our inclusion criteria and were analyzed. RT was prescribed either alone or as an adjuvant treatment. Prescribed RT dose ranged from 22.0 to 70.0 Gy with conventional fractionation or hypo-fractionated schedule and delivered by three-dimensional conformal RT, intensity modulated RT or stereotactic body RT. Grade ≥ 3 acute and grade ≥ 2 late toxicity rates ranged between 0.0% and 52.6% (median: 0.5%) and between 0.0% and 15.0% (median: 0%), respectively. Median overall survival and two-year survival rate were 11.3 months (range: 6.4–69.0 months) and 49.0% (range 6.6–75.5%), respectively. RT in older patients seems to be tolerable and safe particularly in terms of late toxicity irrespective of the treatment settings. Therefore, RT can represent a treatment option in PaC even in an older population. Further analyses and prospective trials enrolling older patients are needed to better define the risk/benefit ratio in different treatment settings.
KW - Older
KW - Pancreatic neoplasms
KW - Radiotherapy
KW - Systematic review
UR - http://www.scopus.com/inward/record.url?scp=85054004376&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85054004376&partnerID=8YFLogxK
U2 - 10.1016/j.jgo.2018.09.007
DO - 10.1016/j.jgo.2018.09.007
M3 - Article
AN - SCOPUS:85054004376
JO - Journal of Geriatric Oncology
JF - Journal of Geriatric Oncology
SN - 1879-4068
ER -