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Abstract Details
Charlson comorbidity index and G8 in older old adult(=80 years) hepatocellular carcinoma patients treated with stereotactic body radiotherapy
Mauro Loi1, Tiziana Comito2, Ciro Franzese3, Isacco Desideri4, Luca Dominici5, Lorenzo Lo Faro2, Elena Clerici2, Davide Franceschini2, Davide Baldaccini2, Marco Badalamenti2, Giacomo Reggiori2, Francesca Lobefalo2, Marta Scorsetti3
Author information
1Humanitas Clinical and Research Center, IRCCS, Radiotherapy and Radiosurgery Department, Rozzano, Italy. Electronic address: mauro.loi@humanitas.it.
2Humanitas Clinical and Research Center, IRCCS, Radiotherapy and Radiosurgery Department, Rozzano, Italy.
3Humanitas Clinical and Research Center, IRCCS, Radiotherapy and Radiosurgery Department, Rozzano, Italy; Radiotherapy Department, University of Florence, Florence, Italy.
4Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan Area, Italy.
5Humanitas Clinical and Research Center, IRCCS, Radiotherapy and Radiosurgery Department, Rozzano, Italy; Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan Area, Italy.
Abstract
Introduction: Hepatocellular Carcinoma (HCC) is characterized, in Western countries, by higher incidence and mortality rates in the older adult population. In frail patients, limited therapeutic resources are available due to limited expected benefit concerning the risk of treatment-related toxicity. The aim of our study is to evaluate the role of Stereotactic Body Radiotherapy (SBRT) in the clinical management of older old adults (age ≥ 80 years) HCC patients and to identify predictors of efficacy and toxicity.
Material and methods: Clinical and treatment-related data of older old adults HCC patients treated with SBRT at our institution were retrospectively reviewed. Statistical analysis was carried out to identify variables correlated with impaired outcome and toxicity.
Results: Forty-two patients were included, accounting for 63 treated tumors. Median age was 85 (range 80-91) years. Median Charlson Comorbidity Index (CCI) and G8 scores were 10 (range 7-16) and 11 (range 8-14), respectively. SBRT was administered to a median BED10 of 103 Gy10. Median follow-up interval was 11 (range 3-40) months. Two years Local Control (LC), Progression-Free Survival (PFS), and Overall Survival (OS) were 93%, 31%, and 43%, respectively. Acute toxicity occurred in 28% (n = 13) of treatments. A G8 score > 10 was associated with improved survival (p = 0.045), while a CCI ≥10 was correlated with increased acute toxicity (p = 0.021).
Conclusions: SBRT is a safe and effective option in older old adults HCC patients. A comprehensive geriatric assessment (CGA) is advised before treatment decisions to select optimal candidates for SBRT.