UNASSIGNED:分析有关老年人中高危前列腺癌(PC)放射治疗的文献。
UNASSIGNED:进行了PubMed文献检索,其中包括2000年1月1日至21年6月30日的文章,关键字如下:PC,放射治疗/近距离放射治疗和老年人。分析主要集中在老年人治疗不足的问题和辐射的利益/风险平衡。
未经评估:在分析的176个参考文献中,24符合选择标准。“老年患者”的定义从70岁到80岁不等。分析受到每个队列中使用的不均匀主要终点的影响。年龄通常是激进治疗的障碍,随后有治疗不足的风险,特别是在预后较差的患者中。然而,将可比较的老年肿瘤结局与年轻患者进行比较,无论是单独使用外束放射治疗还是结合近距离放射治疗。晚期毒性率低,通常与年轻人群相当。然而,超老年人(>80岁)在加强近距离放射治疗后观察到尿毒性过度。应根据合并症考虑使用ADT,甚至可能对某些患者有害。
未经评估:由于预期寿命的增加,老年人的PC管理对患者来说是一个挑战,临床医生和医疗保险付款人。除了不适合的男人,老年患者在进行老年病学评估后仍可选择最佳治疗方案(即不论年龄大小).来自专门针对该人群进行的前瞻性试验的更可靠数据将为我们的日常临床实践提供更好的指导。
UNASSIGNED: To analyze the literature that addresses radiation therapy for intermediate and high-risk prostate cancer (PC) in the elderly.
UNASSIGNED: A PubMed literature search was conducted including articles from 01/01/2000 to 30/06/21, with the following keywords: PC, radiotherapy/brachytherapy and elderly. The analysis mainly focused on the issue of under-treatment in the elderly and the benefit/risk balance of irradiation.
UNASSIGNED: Of the 176 references analyzed, 24 matched the selection criteria. The definition of \"elderly patient\" varied from 70 to 80 years. The analysis was impacted by the inhomogeneous primary end points used in each cohort. Age was often an obstacle to radical treatment, with a subsequent risk of under-treatment, particularly in patients with a poorer prognosis. However, comparable elderly oncological outcomes were compared to younger patients, both with external beam radiotherapy alone or combined with brachytherapy boost. Late toxicity rates are low and most often comparable to younger populations. However, a urinary over- toxicity was observed in the super-elderly (>80 years) after brachytherapy boost. The use of ADT should be considered in light of comorbidities, and may even be deleterious in some patients.
UNASSIGNED: Due to the increase in life expectancy, the management of PC in the elderly is a challenge for patients, clinicians and health insurance payers. Except for unfit men, elderly patients remain candidates for optimal curative treatment (i.e. regardless of age) after oncogeriatric assessment. More solid data from prospective trials conducted specially in this population will provide better guidance in our daily clinical practice.