Older Adult Patients

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bookPart
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2022
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SPRINGER INTERNATIONAL PUBLISHING
Autores
DESIDERI, I.
BRAIN, E.
Citação
Desideri, I.; Karnakis, T.; Brain, E.. Older Adult Patients. In: . Breast Cancer Radiation Therapy: A Practical Guide for Technical Applications: SPRINGER INTERNATIONAL PUBLISHING, 2022. p.359-364.
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Ageing is the most important risk factor for developing cancer. Breast cancer is not an exception to the rule, with a median age of 62 years at diagnosis, depending on the age distribution of the population at risk. In western countries, 40–50% of patients are being diagnosed at age 70 or older. Given the competing risks on mortality with multi-morbidities, a screening tool for frailty is recognized as the gateway to any treatment decision-making in patients aged 70 and older, for personalizing treatment. Indeed, treatment choice requires careful assessment of the benefit–risk ratio and guidance according to a general health status assessment, to avoid jeopardizing functional status and quality of life. This concept applies to any specific local or systemic treatment, showing the need for constant adjustment according to the degree of frailty reversibility. Hypofractionated schedules and partial breast irradiation are approaches increasing attractivity of radiation therapy strategies for older patients to avoid multiple burdensome transportations, while improving selection of cases for which chemotherapy is required, both in adjuvant and metastatic settings, is the main challenge for systemic treatments.
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Referências
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