1
|
Murofushi K, Kuribayashi S, Ohnishi K, Hayakawa S, Tsuchida K, Inoue Y, Ohkawa A, Ishida T, Machitori Y, Nakai K, Takizawa D. Multi-Institutional Fact-Finding Study: Association between Geriatric Assessment and Reduction in Intensity of Radiotherapy for Elderly Cancer Patients without Metastasis. Int J Radiat Oncol Biol Phys 2023; 117:S126-S127. [PMID: 37784325 DOI: 10.1016/j.ijrobp.2023.06.470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Vulnerable patients receive a low-intensity, palliative treatment rather than the standard treatment. Defining vulnerability in terms of standard or reduced radiation intensity can result in appropriate radiotherapy for elderly cancer patients without excessive adverse events and poor outcomes. However, it is difficult to define vulnerability, because radiation oncologists hesitate to include vulnerable patients in clinical trials involving radical radiotherapy. We hypothesized that for elderly cancer patients without metastasis, vulnerability scores, obtained by geriatric assessment (GA), could help in predicting the reduction in radiation intensity determined by radiation oncologists based on their experience. MATERIALS/METHODS In this multicenter prospective study, we enrolled cancer patients (70 years or older) without metastasis. The reduction in radiation intensity was categorized into 3 groups as follows: i) standard schedule of radiotherapy, but conversion of irradiation fields, ii) standard irradiation fields, but converted schedule of radiotherapy, and iii) conversion of radiotherapy schedule and irradiation fields. Standard radiotherapy was defined as recommended doses and radiation fields according to the guidelines for the primary tumors analyzed. GA was performed by calculating geriatric 8 (G8) and vulnerable elders survey (VES-13) scores before radiotherapy and 3-5 and 8-16 weeks after completion of radiotherapy. The primary endpoint was to evaluate the correlation between vulnerability assessed by G8 and change in radiation intensity. RESULTS Between November 2020 and February 2022, 317 patients were included in this study at 13 centers in Japan. The median age was 77 (range, 70-90) years. The primary cancer sites were head and neck, esophagus, lungs, breasts, pancreas, bladder, uterus, and prostate in 63, 22, 62, 48, 6, 5, 26, and 85 patients, respectively. High-precision radiotherapy was performed for 199 patients (63%). Of the 31 patients (10%) whose radiation intensity was reduced, 14, 9, and 8 patients were provided i, ii, and iii category, respectively. Planned radiotherapy was completed for 312 patients (98%). G8 and VES-13 vulnerability scores were obtained for 201 and 61 patients, respectively, before radiotherapy. The mean G8 and VES-13 scores were 13.3 ± 2.4 and 1.8 ± 1.8, 12.9 ± 2.6 and 2.0 ± 2.0, and 13.4 ± 2.4 and 2.0 ± 1.9 before radiotherapy and 3-5 and 8-16 weeks after completion of radiotherapy, respectively. Multivariate analysis revealed that reduction in radiation intensity was significantly associated with vulnerability assessed using VES-13 (p < 0.001) but not G8 (p = 0.06). CONCLUSION An excellent completion rate was obtained for planned radiotherapy, and vulnerability assessed using VES-13, not G8, was associated with the reduction in intensity of radiotherapy.
Collapse
Affiliation(s)
- K Murofushi
- Department of Radiation Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | | | - K Ohnishi
- National Center for Global Health and Medicine, Chiba, Japan
| | - S Hayakawa
- Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | | | - Y Inoue
- Department of Radiation Oncology, Hyogo Cancer Center, Akashi, Japan
| | - A Ohkawa
- Mito Medical Center, Ibaraki, Japan
| | - T Ishida
- Ibaraki Prefectural Central Hospital, Ibaraki Cancer Center, Tsukuba, Japan
| | - Y Machitori
- Tokyo Metropolitan Bokutou Hospital, Tokyo, Japan
| | - K Nakai
- Departement of Radiation Oncology and Proton Medical Research Center, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - D Takizawa
- Hitachi General Hospital, Ibaraki, Japan
| |
Collapse
|
2
|
Karasawa K, Kitou S, Machitori Y, Hayakawa S, Ito K, Ogawa H, Shimizuguchi T, Taguchi K, Shibata Y. Accelerated Hypofractionated Radiation Therapy for the Central and Ultracentral Tumors of the Lung – Analysis of Doses to the Organs at Risk. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
3
|
Shimizuguchi T, Nakajima Y, Miyake Y, Shibata Y, Taguchi K, Ogawa H, Hayakawa S, Ito K, Machitori Y, Nihei K, Karasawa K. Radiation Therapy and Risk of Herpes Zoster in General Cancer Patients: A Propensity Score Matched Analysis. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
4
|
Kito S, Nihei K, Machitori Y, Suda Y, Kanda M, Suganami R, Nakajima Y, Furuya T, Hashimoto S, Karasawa K. Estimation Geometric Uncertainty of Dynamic Tracking Technique for Lung Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
5
|
Shimizuguchi T, Nihei K, Ito K, Ogawa H, Kawamoto T, Kuramoto H, Hayakawa S, Fuse K, Shibata Y, Machitori Y, Fujii M, Karasawa K. Herpes Zoster Following Radiation Therapy: A Single-Institutional Epidemiological Analysis from Patient Database. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
6
|
Karasawa K, Kito S, Okano T, Nihei K, Koh S, Shibata Y, Machitori Y, Shimizuguchi T, Itou K, Tanaka H, Kageyama S. Initial Results of 2 Different Dynamic Tracking Techniques for Stereotactic Body Radiation Therapy for Solitary Lung Tumors. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
7
|
Karasawa K, Ito K, Shibata Y, Hayakawa S, Tanaka H, Shimizuguchi T, Machitori Y, Fujii M, Nihei K, Fuse K, Kawamoto T, Kuramoto H. EP-1211: Prognostic factors in patients with Stage I NSCLC treated with 3-D noncoplanar conformal RT. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32461-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
8
|
Karasawa K, Murata H, Itou K, Shimizuguchi T, Kageyama S, Tanaka H, Machitori Y, Fujii M, Nihei K, Shibata Y, Koh S, Fuse K. Multivariate Analysis of Prognostic Factors in the Patients with Stage I Non-small Cell Lung Cancer Treated With Hypofractionated 3-Dimensional Noncoplanar Conformal Radiation Therapy. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
9
|
Koh S, Machitori Y, Kito S, Nihei K, Shibata Y, Kageyama S, Karasawa K. EP-1165 Technical advantages of dynamic tumor tracking in lung stereotactic body radiation therapy using a gimbaled linac. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41157-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
10
|
Murata H, Okuma Y, Shimizuguchi T, Tanaka H, Machitori Y, Fujii M, Nihei K, Karasawa K. EP-1184: Radiotherapy for thymic carcinoma: A retrospective analysis of 39 patients. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)31302-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
11
|
Nihei K, Hashimoto S, Shimizuguchi T, Tanaka H, Machitori Y, Fujii M, Karasawa K. EP-1606: Planning study of SBRT for localized prostate cancer among VERO, TomoTherapy, and Cyberknife. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)31724-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
12
|
Karasawa K, Shimizuguchi T, Murata H, Kageyama S, Tanaka H, Machitori Y, Chang T, Fujii M, Nihei K, Hanyu N. Radioactive Treatment in Patients With Metastatic Well-Differentiated Thyroid Cancer. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
13
|
Karasawa K, Machitori Y, Shimizuguchi T, Murata H, Kageyama S, Tanaka H, Chang T, Fujii M, Nihei K, Hanyu N. Three-Dimensional Non-Coplanar Conformal Radiation Therapy With 75 Gy/25fr/5w Regimen for the Treatment of Stage I NSCLC: A 10-year Experience. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
14
|
Karasawa K, Machitori Y, Nihei K, Tanaka H, Shimizuguchi T, Murata H, Kageyama S, Chang T, Fujii M. PO-0677: Three dimensional non-coplanar conformal radiotherapy with 75Gy/25fr/5w regimen for the treatment of stage I NSCLC. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)32983-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
15
|
Okano N, Karasawa K, Nihei K, Chang T, Machitori Y, Shimiguchi T, Hanyu N. The Efficacy of 3-dimensional Noncoplanar Conformal Radiation Therapy for T2N0M0 Non-small Cell Lung Cancer Compared With Stereotactic Body Radiation Therapy. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.1558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
16
|
Machitori Y, Hanyu N, Karasawa K, Chang T, Kuga G, Okano N, Mitsui N, Hozumi T. Intraoperative Radiotherapy Combined with Posterior Surgery for Spinal Metastases. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.1922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
|
17
|
Karasawa K, Okano N, Machitori Y, Chang T, Kuga G, Okano T, Hanyu N. Three-Dimensional Non-coplanar Conformal Radiotherapy for the Treatment of Stage I Non-small Cell Lung Cancer: Results of our 9-Year Experience. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.1092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
18
|
Karasawa K, Okano N, Machitori Y, Chang T, Kuga G, Mitsui N, Hanyu N, Kunishima N. 883 poster 3-D NON-COPLANAR CONFORMAL RADIOTHERAPY FOR THE TREATMENT OF STAGE I NSCLC – ITS USEFULNESS FOR CENTRAL TUMORS. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)71005-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|