Elizabeth M. Gore, MD, Professor of Radiation Oncology, Associate Director, Radiation Oncology, Medical College of Wisconsin, elaborates on the increase in toxicity observed in clinical trials for elderly patients with lung cancer.

Toxicity is an important treatment related topic that needs to be considered for all patients, regardless of age. Toxicity is generally higher in elderly patients because they tend to have a lower resilience to therapy, which requires special considerations such as lowering the radiation therapy fields.

Clinical trial data for elderly patients can often be imperfect, generally due to a lack of coordination between observed data and comorbidity or dose volume parameters. It is easy to only examine lung toxicity in a study but not the individual dose or other correlating treatment. In some cases the added toxicity may be more a factor of how the patient was treated and not their age.

Gore notes that regardless of data imperfections it has been shown consistently that toxicity is higher in older patients. This realization may not necessarily lead to a change in practice, but should be mentioned to the patients.

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Dr. Elizabeth Gore, from the Medical College of Wisconsin, on Toxicity in Elderly Lung Cancer Patients

Dr. Gore on Toxicity in Elderly Lung Cancer Patients

Elizabeth M. Gore, MD, Professor of Radiation Oncology, Associate Director, Radiation Oncology, Medical College of Wisconsin, discusses the benefits of using hypofractionated instead of conventional radiation therapy.

Hypofractionated radiation is the process of delivering a higher dose of radiation over a shorter period of time. The current standard in locally advanced lung cancer for a curative treatment provides 3D conformal radiation every day for 6 weeks.

The shorter course of treatment that hypofractionated radiotherapy delivers decreases treatment to 15 visits over a 3 week period, providing 3-Gy per fraction for a total of 45-Gy. Data suggest this method is just as effective as conventional radiation, which provides 60-Gy over the course of 6 weeks.

Additionally, hypofractionation is less of a burden for the patient, and is a way to customize care for patients that cannot otherwise tolerate a full course of treatment or are unwilling to come in for treatment every day for 6 weeks.

Dr. Elizabeth Gore, from the Medical College of Wisconsin, Discusses Hypofractionated Radiotherapy

Elizabeth M. Gore, MD

Articles

Dr. Gore on Toxicity in Elderly Lung Cancer Patients

Dr. Gore on Hypofractionated Radiation Therapy