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Frailty—the missing constraint in radiotherapy treatment planning for older adults

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Abstract

Current demographic changes translate into an increased frequency of cancer in older adults. Available data show that about 45–55% of the new cancer patients will need RT treatments, with an expected increase of 20–30% in the future. To provide the best cancer care it is mandatory to assess frailty, offer appropriate curative treatments to patients and personalise them for the frail. Based on published data, the median prevalence of frailty in older population is about 42%. Recently, the free radical theory of frailty has been proposed stating that oxidative damage is more prevalent in frail patients. In parallel, RT is one of the most frequent cancer treatments offered to older adults and is a source of external free radicals. RT dose constraints correlate with toxicity rates, so we open the question whether frailty should be considered when defining these constraints. Thus, for this paper, we will highlight the importance of frailty evaluation for RT treatment decisions and outcomes.

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Acknowledgements

The authors would like to acknowledge the support and opportunity provided by EIT Health Ageing PhD School, within the module “Frailty in Real-Life and its translational aspects” organized by the University of Cologne.

Funding

E.D.R. is funded by FCT – Fundação para a Ciência e Tecnologia and the European Social Fund, namely, the Northern Regional Operational Programme (Norte 2020), the Centre's Regional Operational Programme (Centro 2020) and the Alentejo Regional Operational Programme (Alentejo 2020)—(BD/151449/2021).

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Author notes

  1. D. Gonsalves, L. Teixeira, E. López have contributed equally to this work.

Authors and Affiliations

  1. Departamento de Estudo de Populações, ICBAS, Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Rua de Jorge Viterbo Ferreira, n° 228, 4050-313, Porto, Portugal

    Edna Darlene Rodrigues & Laetitia Teixeira

  2. Center for Health Technology and Services Research, CINTESIS, Rua Dr. Plácido da Costa, s/n, 4200-450, Porto, Portugal

    Edna Darlene Rodrigues & Laetitia Teixeira

  3. EIT Health Ageing PhD School, Munich, Germany

    Edna Darlene Rodrigues

  4. GenesisCare en Madrid, Hospital San Francisco de Asís, Calle de Joaquín Costa, 28, 28002, Madrid, Spain

    Daniela Gonsalves

  5. GenesisCare en Madrid, Hospital Vithas La Milagrosa, Calle de Modesto Lafuente, 14, 28010, Madrid, Spain

    Escarlata López

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Correspondence to Edna Darlene Rodrigues.

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Rodrigues, E.D., Gonsalves, D., Teixeira, L. et al. Frailty—the missing constraint in radiotherapy treatment planning for older adults. Aging Clin Exp Res 34, 2295–2304 (2022). https://doi.org/10.1007/s40520-022-02200-1

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