ESTRO 2024 - Abstract Book

S22 ESTRO 2024 Age itself determines physiological changes in organ function and pharmacokinetics, concomitant diseases are more frequent, significantly affecting the functional, psychological status and general performance. Hence, survival benefits may decline and the risks associated with treatment may increase with age. Therefore, preservation and improvement of quality of life (QoL) should be one of the major goals of geriatric population. Health-related QoL assessment together with frailty assessment should be the most important tools for decision-making in elderly population. There is currently no consensus about the definition of QoL as well as how it should be measured, however evaluation of QoL at the beginning of treatment seems to have an independent prognostic implications. QoL assessment may help with decisions in terms of aggressiveness of treatment, life-prolongation and palliative treatments. Elderly patients are underrepresented in clinical trials in the field of gynecologic oncology. As elderly population is a fast growing proportion of general population we urgently need clinical trials in this specific population to be able to provide clinical guidelines. It has been shown that ovarian cancer patients treated in hospitals participating in clinical trials had a significantly higher chance of better surgical treatment and chemotherapy regimen (92% vs. 58%). Due to physiological changes in organ function and pharmacokinetics associated with increasing age performing clinical trials is mandatory as extrapolation of results from younger patients may not be feasible. There are only very limited number of trials in this field. However, some studies showed that elderly patients are generally willing to participate in clinical trials, regardless of their fitness; although the benefits of participating in trials were not very clear among cohort being studied. As management of elderly patients having gynecologic cancers is challenging care-providers need to obtain special knowledge, experience and skills. The survey among different profiles of care-providers in UK showed that frailty scoring was not routinely performed in 63% of care settings and only 16 % of organisations surveyed had a dedicated pathway for assessment and management of frail patients. Also young trainees in gynecologic oncology reported inadequate training in peri-operative care of frail patients. Elderly cancer population remains vulnerable due to under-treatment, lack of routine frailty and QoL assessment, under representation in clinical trials with low amount of scientific evidence to establish guidelines and lack of proper training and clinical pathways for providers of care. Invited Speaker