The use of radiotherapy in oncology patients aged 80 years and older represents a significant clinical challenge due to the limited availability of prospective data and the under-representation of this age group in clinical trials. Most existing evidence originates from retrospective analyses of small patient cohorts. Radiotherapy remains a cornerstone of cancer treatment, providing both curative and palliative benefits. Technological advances, including intensity-modulated radiotherapy (IMRT) and stereotactic body radiotherapy (SBRT), have significantly improved treatment precision, reduced toxicity, and enabled the adoption of hypofractionated regimens. These shortened treatment schedules are particularly advantageous for older patients, reducing the burden of prolonged therapy while maintaining therapeutic efficacy. Comprehensive Geriatric Assessment (CGA) plays a crucial role in optimizing treatment decisions for octogenarian patients by addressing their clinical, functional, and psychosocial needs. However, the routine use of CGA remains limited due to logistical and time constraints. Despite these challenges, current evidence suggests that radiotherapy is generally well tolerated in this population, with acceptable toxicity profiles even among frail patients. As the global population of individuals aged 80 years and older continues to increase, the development of specific clinical guidelines tailored to this demographic has become essential. There is an urgent need for prospective studies providing robust evidence regarding the efficacy, safety, and tolerability of radiotherapy in older adults. This review aims to summarize the current state of knowledge on the role of radiotherapy in patients aged 80 years and older and to highlight the need for evidence-based, individualized oncologic care for this growing patient population.
在80岁及以上老年肿瘤患者中应用放射治疗是一项重大的临床挑战，这主要源于前瞻性数据的缺乏以及该年龄组在临床试验中的代表性不足。现有证据大多来自小规模患者队列的回顾性分析。放射治疗作为肿瘤治疗的基石，兼具根治性与姑息性治疗价值。随着调强放疗（IMRT）和立体定向体部放疗（SBRT）等技术的发展，治疗精准度显著提升，毒性反应降低，并推动了低分割放疗方案的应用。这种缩短疗程的治疗模式对老年患者尤为有利，能在维持疗效的同时减轻长期治疗负担。综合老年评估（CGA）通过全面评估患者的临床、功能及社会心理需求，对优化高龄患者的治疗决策具有关键作用，但受限于实施条件与时间成本，其常规应用仍不充分。尽管存在诸多挑战，现有证据表明该人群对放疗普遍耐受良好，即使衰弱患者也呈现出可接受的毒性特征。随着全球80岁以上人口持续增长，制定针对该群体的专项临床指南已迫在眉睫。当前亟需开展前瞻性研究，为老年患者放疗的有效性、安全性和耐受性提供有力证据。本文旨在综述放疗在80岁及以上患者中应用的现有认知，并强调为这一不断扩大的患者群体提供循证化、个体化肿瘤治疗的必要性。
肿瘤(癌症)患者之家