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...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-07-01
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| Series: | Clinical and Translational Radiation Oncology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405630822000301 |
| _version_ | 1811245855476285440 |
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| author | Delphine Marotte Marie-Eve Chand-Fouche Rabia Boulahssass Jean-Michel Hannoun-Levi |
| author_facet | Delphine Marotte Marie-Eve Chand-Fouche Rabia Boulahssass Jean-Michel Hannoun-Levi |
| author_sort | Delphine Marotte |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-04-12T14:45:35Z |
| format | Article |
| id | doaj.art-c89ae346531f40539b34de1a2b2c7893 |
| institution | Directory Open Access Journal |
| issn | 2405-6308 |
| language | English |
| last_indexed | 2024-04-12T14:45:35Z |
| publishDate | 2022-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical and Translational Radiation Oncology |
| spelling | doaj.art-c89ae346531f40539b34de1a2b2c78932022-12-22T03:28:40ZengElsevierClinical and Translational Radiation Oncology2405-63082022-07-013518Irradiation of localized prostate cancer in the elderly: A systematic literature reviewDelphine Marotte0Marie-Eve Chand-Fouche1Rabia Boulahssass2Jean-Michel Hannoun-Levi3Department of Radiation Oncology, Antoine Lacassagne Cancer Center, University of Côte d’Azur, 33 avenue Valombrose, 06189 Nice Cedex 2, Nice, FranceDepartment of Radiation Oncology, Antoine Lacassagne Cancer Center, University of Côte d’Azur, 33 avenue Valombrose, 06189 Nice Cedex 2, Nice, FranceGeriatric Coordination Unit for Geriatric Oncology (UCOG) PACA Est, CHU de NICE, University of Cote d’Azur, Oncoage Nice, FranceDepartment of Radiation Oncology, Antoine Lacassagne Cancer Center, University of Côte d’Azur, 33 avenue Valombrose, 06189 Nice Cedex 2, Nice, France; Corresponding author at: Department of Radiation Oncology, Antoine Lacassagne Cancer Center – University Cote d’Azur, 33 Avenue Valombrose, 06107 Nice CEDEX, France.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.http://www.sciencedirect.com/science/article/pii/S2405630822000301Prostate cancerElderlyRadiation therapyBrachytherapyAndrogen deprivation therapy |
| spellingShingle | Delphine Marotte Marie-Eve Chand-Fouche Rabia Boulahssass Jean-Michel Hannoun-Levi Irradiation of localized prostate cancer in the elderly: A systematic literature review Clinical and Translational Radiation Oncology Prostate cancer Elderly Radiation therapy Brachytherapy Androgen deprivation therapy |
| 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 | Prostate cancer Elderly Radiation therapy Brachytherapy Androgen deprivation therapy |
| url | http://www.sciencedirect.com/science/article/pii/S2405630822000301 |
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