Can Comprehensive Geriatric Assessment Predict Tolerance of Radiotherapy for Localized Prostate Cancer in Men Aged 75 Years or Older?

Curative radiotherapy for prostate cancer is common in the elderly. However, concerns about potential toxicity have inhibited access to radiotherapy for this population, for whom preserving quality of life (QoL) is crucial. The primary endpoint was to identify predictors of impaired QoL in men aged 75 years or older treated with curative intent radiotherapy with or without androgen deprivation therapy (ADT) for localized prostate cancer. We prospectively performed comprehensive geriatric assessment (CGA) and administered QoL questionnaires to 208 elderly (>75 years) patients prior to, plus two and six months after, radiotherapy (NCT02876237). The median age of the patients was 77 years (range 75-89). At the start of the study, comorbidities were highlighted in 65% of patients: 23% were depressed, 23% had cognitive impairment, and 16% had reduced independence. At six months, 9% of patients had a consistently decreased QoL (>20 points), and a further 16% had a more moderate reduction (10 to 20 points) in QoL. None of the parameters studied (tumor characteristic, treatment, or oncogeriatric parameters) were predictive of a reduced QoL following radiotherapy. Though co-existing geriatric impairment was common, QoL was maintained for 75% of patients six months after radiotherapy. CGA was poorly predictive of tolerance of prostatic radiotherapy. Geriatric assessments dedicated to quality of life following radiotherapy need to be developed.

Cancers. 2020 Mar 09*** epublish ***

Aurore Goineau, Loïc Campion, Jean-Marie Commer, Brigitte Vié, Agnès Ghesquière, Guillaume Béra, Didier Jaffres, Nicolas Magné, Xavier Artignan, Jérôme Chamois, Philippe Bergerot, Gilles Créhange, Elisabeth Deniaud-Alexandre, Xavier Buthaud, Yazid Belkacémi, Mélanie Doré, Laure De Decker, Stéphane Supiot

Department of Radiation Oncology, Institut de Cancérologie de l'Ouest, 49000 Angers, France., Department of Statistics, Institut de Cancérologie de l'Ouest, CRCINA, University of Nantes, INSERM UMR1232, CNRS-ERL6001, 44800 Saint Herblain, France., Department of Radiation Oncology, Clinique Armoricaine de Radiologie, 22000 St Brieuc, France., Department of Radiation Oncology, Centre Hospitalier de Bretagne Sud, 56100 Lorient, France., Department of Radiation Oncology, Institut de Cancérologie de Loire, 42270 St Priest en Jarez, France., Department of Radiation Oncology, CHP St Grégoire, 35760 St Grégoire, France., Department of Radiation Oncology, Clinique Mutualiste de l'Estuaire, 44600 St Nazaire, France., Department of Radiation Oncology, Centre Georges François Leclerc, 21000 Dijon, France., Department of Radiation Oncology, Centre Hospitalier Départemental de Vendée, 85000 La Roche sur Yon, France., Department of Radiation Oncology, Centre Catherine de Sienne, 44000 Nantes, France., Department of Radiation Oncology, CHU Henri Mondor, 94000 Créteil, France., Department of Radiation Oncology, Institut de Cancérologie de l'Ouest, 44800 Saint Herblain, France.