Donato Vittorio, Valeriani Maurizio, Zurlo Alfredo
Radiotherapy, Institute of Radiology, University of Study of Rome La Sapienza, Via San Cipriano 60, 00136 Rome, Italy.
Crit Rev Oncol Hematol. 2003 Mar;45(3):305-11. doi: 10.1016/s1040-8428(02)00082-3.
The choice of the appropriate treatment strategy for elderly cancer patients may be a difficult challenge. Radiation therapy is commonly offered to these patients, but treatment duration may represent a limiting factor, as many patients cannot tolerate a conventional course of radiotherapy (RT) due to age-related medical or logistic problems. Hypofractionated RT may represent a very convenient choice, but it entails an increased risk of late toxicity occurrence. We made a literature review to define the possible role of hypofractionated RT for elderly cancer patients. As expected, we found out that short irradiation schedules are more commonly employed for treatments with palliative aims but a more widespread use of these regimes is still controversial. The lack of prospective trials tailored for these patients makes even more difficult to tailor the choice of treatment on standardised treatment guidelines. Nevertheless our review highlights that for several tumour types RT can be scheduled conveniently and effectively in order to achieve local disease control and/or symptom relief with the least discomfort and treatment-related morbidity for elderly patients.
为老年癌症患者选择合适的治疗策略可能是一项艰巨的挑战。放射治疗通常适用于这些患者，但治疗持续时间可能是一个限制因素，因为许多患者由于与年龄相关的医疗或后勤问题无法耐受传统的放射治疗疗程。短程放疗可能是一个非常方便的选择，但它会增加迟发性毒性发生的风险。我们进行了文献综述，以确定短程放疗在老年癌症患者中的可能作用。正如预期的那样，我们发现短疗程照射更常用于以姑息为目的的治疗，但这些方案的更广泛应用仍存在争议。缺乏针对这些患者的前瞻性试验使得根据标准化治疗指南调整治疗选择变得更加困难。尽管如此，我们的综述强调，对于几种肿瘤类型，可以方便且有效地安排放疗，以便在老年患者最少的不适和与治疗相关的发病率的情况下实现局部疾病控制和/或症状缓解。
