Practical brachytherapy solutions to an age-old quandary. (December 2020)

• Record Type: Journal Article
• Authors: Thiruthaneeswaran, N.; Tharmalingam, H.; Hoskin, P.J.
• Is Part Of: Technical innovations & patient support in radiation oncology. Volume 16(2020)
• Page Start: 39
• Page End: 47
• Publication Date: 2020-12
• Subjects: Brachytherapy -- High dose-rate (HDR) -- Geriatric oncology -- Elderly -- Radiotherapy; Radiotherapy -- Periodicals; Cancer -- Radiotherapy -- Periodicals; Cancer -- Patients -- Hospital care -- Periodicals; 615.842
• DOI: 10.1016/j.tipsro.2020.09.004
• Languages: English
• ISSNs: 2405-6324

Abstract

Highlights: Age should not be a limiting factor for brachytherapy in patients with localised cancer or for palliation in metastatic disease. In tumour streams where brachytherapy forms part of the curative management, it should not be omitted in elderly patients who are medically fit for treatment. Treatment decisions should factor in patient preferences, the relative merits of different therapeutic approaches and maintaining minimal impact on quality of life. Abstract: Cancer is predominantly a disease of the elderly and as population life expectancy increases, so will the incidence of malignant disease. Elderly patients often have other comorbidities and social complexities, increasing the support required to safely deliver all treatment modalities. Brachytherapy is a relatively simple technique by which radiation therapy can be delivered. It offers dosimetric advantages through a highly conformal dose distribution thereby limiting radiation exposure to normal tissues reducing toxicity. Requiring fewer hospital visits, it also offers practical and logistical advantages to the elderly population and in many cases can be performed without the need for general anaesthesia. In tumour streams where brachytherapy forms part of the curative management, it should not be omitted in elderly patients who are medically fit for treatment. In the palliative setting, brachytherapy often offers an excellent means for achieving either local tumour and/or symptom control and should be actively considered in the therapeutic armamentarium of the oncologist in this context.