ReviewClinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico2026
Recommendations from the Geriatric Oncology Working Group of the Spanish Society of Radiation Oncology for the treatment of elderly patients with radiotherapy.
Review in Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Population ageing is increasing the number of older adults diagnosed with cancer, many of whom require radiotherapy (RT). This population is highly heterogeneous and frequently underrepresented in clinical trials, making treatment decisions particularly challenging. This review, developed by the Geriatric Oncology Working Group of the Spanish Society of Radiation Oncology (SEOR), provides practical recommendations for optimizing RT in elderly patients with cancer based on current evidence and expert consensus. Comprehensive geriatric assessment (CGA) is highlighted as the cornerstone of individualized care, enabling evaluation of functional status, comorbidities, cognition, nutritional status, and social factors. A two-step approach, consisting of an initial screening followed by CGA when indicated, is recommended to identify vulnerable patients and support clinical decision-making. Integration of geriatric assessment allows classification of patients as robust, vulnerable, or frail, facilitating personalized treatment strategies. Chronological age alone is not a reliable predictor of RT tolerance, whereas functional reserve and frailty are critical determinants of outcomes. Advanced RT techniques and hypofractionated schedules may improve treatment accessibility and reduce patient burden without compromising efficacy. Adaptation of treatment, including radiation dose, target volumes, and combined therapies, should be tailored to individual patient characteristics. Supportive interventions such as nutritional optimization, physical exercise, and symptom management are essential to improve treatment tolerance and quality of life. Multidisciplinary care and the incorporation of patient-reported outcomes further contribute to patient-centered management. Overall, RT in older patients should be individualized according to geriatric assessment rather than age alone, and CGA-driven strategies, personalized treatment adaptation, and integrated supportive care are key to optimizing outcomes. Further research focusing on frail older populations is warranted.
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