Should Older Cancer Patients Receive Priority for Coronavirus Disease 19 Vaccination: Recommendation of the International Geriatric Radiotherapy Group

2021 ◽  
Vol 04 (01) ◽  
Author(s):  
Nam P. Nguyen ◽  
Vincent Vinh-Hung ◽  
Ulf Karlsson
Gerontology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Nam Phong Nguyen ◽  
Brigitta G. Baumert ◽  
Eromosele Oboite ◽  
Micaela Motta ◽  
Gokula Kumar Appalanaido ◽  
...  

<b><i>Background:</i></b> Older cancer patients with locally advanced or metastatic disease may benefit from chemotherapy alone or combined with radiotherapy. However, chemotherapy is often omitted either because of physician bias or because of its underlying comorbidity, thus compromising their survival. The coronavirus disease 19 (COVID-19) pandemic is compounding this issue because of the fear of immunosuppression induced by chemotherapy on the elderly which makes them more vulnerable to the virus. <b><i>Summary:</i></b> Immunotherapy has less effect on the patient bone marrow compared to chemotherapy. The potential synergy between radiotherapy and immunotherapy may improve local control and survival for older patients with selected cancer. Preliminary data are encouraging because of better survival and local control in diseases which are traditionally resistant to radiotherapy and chemotherapy such as melanoma and renal cell carcinoma. <b><i>Key Message:</i></b> We propose a new paradigm combining immunotherapy at a reduced dose and/or extended dosing intervals and hypofractionated radiotherapy for older patients with selected cancer which needs to be tested in future clinical trials.


Cancers ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 371 ◽  
Author(s):  
Tiberiu Popescu ◽  
Ulf Karlsson ◽  
Vincent Vinh-Hung ◽  
Lurdes Trigo ◽  
Juliette Thariat ◽  
...  

The management of older cancer patients remains difficult because of data paucity. Radiation oncologists need to identify potential issues which could affect treatment of those patients. A workshop was organized in Barcelona among international radiation oncologists with special interest in the management of older cancer patients on April 22, 2018. The following consensus was reached: 1. Older cancer patients often faced unconscious discriminating bias from cancer specialists and institutions because of their chronological age. 2. Advances in radiotherapy techniques have allowed patients with multiple co-morbidities precluding surgery or systemic therapy to achieve potential cure in early disease stages. 3. The lack of biomarkers for frailty remains an impediment to future research. 4. Access to healthcare insurance and daily transportation remains an issue in many countries; 5. Hypofractionation, brachytherapy, or stereotactic techniques may be ideally suited for older cancer patients to minimize transportation issues and to improve tolerance to radiotherapy. 6. Patients with locally advanced disease who are mentally and physically fit should receive combined therapy for potential cure. 7. The role of systemic therapy alone or combined with radiotherapy for frail patients needs to be defined in future clinical trials because of targeted agents or immunotherapy may be less toxic compared to conventional chemotherapy.


2006 ◽  
Author(s):  
J. Jansen ◽  
J. van Weert ◽  
S. van Dulmen ◽  
T. Heeren ◽  
J. M. Bensing

Aging Health ◽  
2006 ◽  
Vol 2 (6) ◽  
pp. 919-930 ◽  
Author(s):  
Ajay Sandhu ◽  
Arno J Mundt

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