POSTOPERATIVE RADIOTHERAPY AND COMORBIDITY ASSESSMENT IN OLDER AND OLDEST ELDERLY ENDOMETRIAL CANCER PATIENTS: A RETROSPECTIVE ANALYSIS

The purpose of this study was to evaluate the impact of adjuvant radiotherapy, in terms of feasibility and activity, in women aged ≥ 75 years with endometrial cancer. From January 2000 to December 2009, 53 consecutive patients aged 75 years or older received an adjuvant treat- ment program after hysterectomy and bilateral salpingo-oophprectomy. Forty-three out of 53 pa - tients received external radiotherapy and vaginal cuff brachytherapy. In 10 women, vaginal cuff brachytherapy alone was delivered. Ten out of 53 received chemotherapy. Variables considered were age, depth of myometrial infiltration and FIGO grade, co-morbidity, performance status, RT dose, brachytherapy and chemotherapy. The mean age was 78.3 years (range 75-88 years). A total of 11.3% of the patients had no co-morbidity, 58.6% mild, 28.3% moderate, and 1.9% had severe co-mor- bidities. All patients completed the planned radiation schedule. At a median follow-up of 53 months, the 5-year overall survival rate was 72.3%. There was a better survival for patients with no or mild co-morbidities (p < 0.0001). No difference in acute and late toxicity rates was found between patients with different ACE-27 (Adult Comorbidity Evaluation-27) indexes and for different age. We con - clude that compliance with adjuvant radiotherapy is good and rate of toxicity is acceptable in eld - erly patients. Patients with no or mild co-morbidities have a significantly better survival. Increasing severity of co-morbidity may sufficiently shorten remaining life expectancy to cancel gains with ad - juvant radiotherapy. Further prospective trials are needed to confirm these results.