The role of ablative radiotherapy in older adults with limited metastatic disease Review
| Authors: | Diplas, B. H.; Santos, P. M. G.; Shahrokni, A.; Warner, A.; Iyengar, P.; Yang, J. T.; Gomez, D. R.; Palma, D. A.; Tsai, C. J. |
| Review Title: | The role of ablative radiotherapy in older adults with limited metastatic disease |
| Abstract: | For patients with oligometastatic cancer, radiotherapy presents a promising avenue for achieving meaningful symptom relief and durable disease control. Data from recently published and ongoing randomized studies are helping to define the appropriate contexts for effective intervention with stereotactic ablative body radiotherapy (SABR) in the oligometastatic setting. Importantly, older adults represent a significant portion of patients with oligometastatic disease, yet often comprise a minority of patients in clinical trials. Moreover, older adults of the same chronologic age may have variable degrees of fitness and frailty. In this review, we highlight the specific challenges and considerations for the use of radiotherapy for older adults with oligometastatic disease—noting the importance of geriatric assessments in clinical decision-making about the appropriateness of SABR and other metastasis-directed therapies in this population. We then review data from existing trials, including a subset analysis of adverse events and survival estimates among older adults enrolled in the landmark SABR-COMET trial. Finally, we discuss future directions for research, including the need for focused clinical trials in older adult cohorts. Ultimately, a multidisciplinary approach is critical when carefully balancing the potential risks and benefits of this emerging treatment paradigm in the older adult population. |
| Keywords: | aged; geriatric assessment; decision making, clinical; radiosurgery -- methods -- in old age; radiosurgery -- utilization -- in old age; neoplasm metastasis -- therapy -- in old age; ablation techniques -- in old age |
| Journal Title: | Seminars in Radiation Oncology |
| Volume: | 32 |
| Issue: | 2 |
| ISSN: | 1053-4296 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2022-04-01 |
| Start Page: | 135 |
| End Page: | 141 |
| Language: | English |
| DOI: | 10.1016/j.semradonc.2021.11.009 |
| PROVIDER: | EBSCOhost |
| PROVIDER: | cinahl |
| PUBMED: | 35307115 |
| DOI/URL: | |
| Notes: | Accession Number: 155844689 -- Entry Date: 20220324 -- Revision Date: 20220324 -- Publication Type: Article; review -- Journal Subset: Biomedical; Expert Peer Reviewed; Peer Reviewed; USA -- NLM UID: 9202882. -- Source: Cinahl |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work