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Irradiation of localized prostate cancer in the elderly: A systematic literature review
PURPOSE: To analyze the literature that addresses radiation therapy for intermediate and high-risk prostate cancer (PC) in the elderly. PATIENTS AND METHODS: A PubMed literature search was conducted including articles from 01/01/2000 to 30/06/21, with the following keywords: PC, radiotherapy/brachyt...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9046879/ https://www.ncbi.nlm.nih.gov/pubmed/35492872 http://dx.doi.org/10.1016/j.ctro.2022.04.006 |
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author | Marotte, Delphine Chand-Fouche, Marie-Eve Boulahssass, Rabia Hannoun-Levi, Jean-Michel |
author_facet | Marotte, Delphine Chand-Fouche, Marie-Eve Boulahssass, Rabia Hannoun-Levi, Jean-Michel |
author_sort | Marotte, Delphine |
collection | PubMed |
description | PURPOSE: To analyze the literature that addresses radiation therapy for intermediate and high-risk prostate cancer (PC) in the elderly. PATIENTS AND METHODS: 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. RESULTS: 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. CONCLUSION: 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. |
format | Online Article Text |
id | pubmed-9046879 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-90468792022-04-29 Irradiation of localized prostate cancer in the elderly: A systematic literature review Marotte, Delphine Chand-Fouche, Marie-Eve Boulahssass, Rabia Hannoun-Levi, Jean-Michel Clin Transl Radiat Oncol Review Article PURPOSE: To analyze the literature that addresses radiation therapy for intermediate and high-risk prostate cancer (PC) in the elderly. PATIENTS AND METHODS: 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. RESULTS: 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. CONCLUSION: 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. Elsevier 2022-04-20 /pmc/articles/PMC9046879/ /pubmed/35492872 http://dx.doi.org/10.1016/j.ctro.2022.04.006 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Review Article Marotte, Delphine Chand-Fouche, Marie-Eve Boulahssass, Rabia Hannoun-Levi, Jean-Michel Irradiation of localized prostate cancer in the elderly: A systematic literature review |
title | Irradiation of localized prostate cancer in the elderly: A systematic literature review |
title_full | Irradiation of localized prostate cancer in the elderly: A systematic literature review |
title_fullStr | Irradiation of localized prostate cancer in the elderly: A systematic literature review |
title_full_unstemmed | Irradiation of localized prostate cancer in the elderly: A systematic literature review |
title_short | Irradiation of localized prostate cancer in the elderly: A systematic literature review |
title_sort | irradiation of localized prostate cancer in the elderly: a systematic literature review |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9046879/ https://www.ncbi.nlm.nih.gov/pubmed/35492872 http://dx.doi.org/10.1016/j.ctro.2022.04.006 |
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