Radiation therapy in older adult patients with cervical cancer: A single-center retrospective study

Purpose: The number of older adult patients with uterine cervical cancer is continuously increasing in Japan. This study aimed to investigate the patient characteristics, treatment outcomes, and adverse effects (AEs) of older adult patients with cervical cancer. Methods: We retrospectively analyzed 89 patients who had undergone definitive radiation therapy (RT). Based on patient age at the time of study inclusion, patients were divided into the older (≥ 75 years [n = 21]) and younger (< 75 years [n = 68]) adult groups, between which the patient characteristics and three-year cumulative overall survival (OS) and progression-free survival (PFS) rates were compared. We assessed potential prognostic factors, the association between reductions in Eastern Cooperative Oncology Group (ECOG) performance status (PS) before treatment and six months post-treatment, and treatment-related factors. Results: Histological type (adenocarcinoma) was associated with OS, whereas average Hb concentration during treatment was associated with PFS in older adult patients. Moreover, the external beam RT field, concurrent chemotherapy dose, and overall treatment time were not associated with a worsening of ECOG PS among older adult patients. Acute AEs of grade ≥ 3 were significantly more common in the younger adult group; however, three of the older adult patients (14%) had Grade 3 leukopenia, and two were concurrently receiving ≥ 200 mg of cisplatin. Conclusion: Concurrent chemoradiation therapy may cause severe leukopenia in older adult patients; therefore, it should be considered carefully in older adult patients with cervical cancer.