S910
Clinical - Mixed sites & palliation
ESTRO 2026
Digital Poster 4105 Radiotherapy in Patients Aged ≥90 Years: Propensity-Matched Comparison With Those Aged 75–89 Yumi Kokubo, Yurie Tsutsumi, Kiyotomo Matsugi, Tomohiro Ono, Chikako Yamauchi Radiation therapy, Shiga General Hospital, Moriyama, Japan Purpose/Objective: In Japan, radiotherapy (RT) across all ages is covered under universal health insurance, and opportunities to treat nonagenarians have increased with population aging. This study compared post-RT outcomes and safety between patients aged ≥ 90 years and those aged 75–89 years using propensity-score matching (PSM). Material/Methods: We retrospectively identified patients who received RT at our institution between January 2011 and July 2024 and were aged ≥ 75 years at the time of RT. Patients who underwent RT for benign disease were excluded. Patients were grouped as nonagenarians ( ≥ 90) versus younger older adults (75–89 years) (YOA). One-to-one PSM was performed using the following covariates: (1) primary tumor site, (2) Union for International Cancer Control stage, (3) Eastern Cooperative Oncology Group performance status, (4) sex, (5) treatment site, (6) prescribed total dose, (7) concurrent chemotherapy (yes/no), (8) treatment intention (curative/palliative), (ix) irradiation technique (conventional/ Stereotactic Body Radio Therapy/ Intensity Modulated Radiation Therapy), and (x) inpatient stay (outpatient/inpatient). Overall survival (OS) was calculated and compared by the Kaplan–Meier method with the log-rank test. Acute adverse events (AAEs) investigated based on Common Terminology Criteria for Adverse Events v. 5.0. The incidences of grade ≥ 2 and ≥ 3 AEs were compared with Fisher’s exact test. Factors associated with OS were explored using Cox proportional hazards models. P values < 0.05 were considered statistically significant. Results: During the study period, we identified 88 patients aged ≥ 90 years and 2,288 patients aged 75–89 years who received RT. After PSM, 68 patients per group were included in the analysis. Median prescribed dose was 30 Gy in the nonagenarians group and 39 Gy in the YOA group (p = 0.95). Median OS was 8 months versus 10 months, and 3-month OS rates were 75% versus 71%, with no significant difference (p = 0.37). RT completion rates were 97% versus 99% (p = 1). The
Conclusion: The exponential publication growth highlights the critical need for a living systematic review with continuous updates to inform evidence-based clinical decision-making. Traditional static reviews become outdated rapidly in this early and dynamic field. This biannually-updated living systematic review, accessible via an online platform and mobile application, provides clinicians with current evidence to guide treatment decisions involving combined local and systemic therapies. References: 1. Kroeze, S. G. C. et al. Lancet Oncol. 24, e121–e132 (2023). PMID: 368587282. van Aken ESM, et al. Ann Oncol. 2025 Sep 26:S0923-7534(25)04719-2. PMID: 410166003. Lebow, E. S. et al. Adv. Radiat. Oncol. 10, 101714 (2025). PMID: 400921564. Chun, S.- J. et al. Radiother. Oncol. J. Eur. Soc. Ther. Radiol. Oncol. 199, 110461 (2024). PMID: 390677065. Stumpf, P. K. et al. Clin. Cancer Res. Off. J. Am. Assoc. Cancer Res. 25, 3946–3953 (2019). PMID: 309406546. Lebow, E. S. et al. JAMA Oncol. 9, 1729–1733 (2023). PMID: 378830797. Seyedin, S. N. et al. Clin. Genitourin.
Cancer 22, 102243 (2024). PMID: 39520850 Keywords: living systematic review, SBRT
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