Mongiat-Artus P, Peyromaure M, Richaud P, Beuzeboc P, Bastide C, Cornud F, Gaschignard N, Molinié V, Rozet F, Staerman F, Soulié M, Salomon L
Service d'Urologie, Hôpital Saint-Louis, Paris, France.
Prog Urol. 2009 Nov;19 Suppl 3:S151-5. doi: 10.1016/S1166-7087(09)73363-9.
Prostate cancer (PaC) is a significant health problem. Elderly have the highest incidence of the disease as age is its strongest risk factor. Despite its complications, the use of androgen suppression in aging patients with prostate cancer has become extremely frequent with probable excess. However, some of these complications carry specific mortality and all of them have a negative impact on quality of life. It is critical to perform a geriatric assessment, concerning physical, mental and social items, before to consider androgen suppression in this population. Indications of androgen suppression for the treatment of prostate cancer follow the guidelines of CCAFU. Delayed treatment deserves a special attention when possible. Treatment modalities are no specific to the elderly, but complications have to be anticipated with preventive measures. Intermittent androgen suppression should be considered with caution. Close follow up will focus on the diagnosis of adverse effects of androgen suppression.
前列腺癌(PaC)是一个重大的健康问题。老年人中该疾病的发病率最高,因为年龄是其最强的风险因素。尽管存在并发症,但在老年前列腺癌患者中使用雄激素抑制疗法已变得极为频繁,可能存在过度使用的情况。然而,其中一些并发症具有特定的死亡率,并且所有并发症都会对生活质量产生负面影响。在考虑对该人群进行雄激素抑制治疗之前,进行涉及身体、心理和社会方面的老年评估至关重要。治疗前列腺癌的雄激素抑制疗法的适应症遵循CCAFU指南。可能的情况下,延迟治疗值得特别关注。治疗方式并非老年人所特有,但必须通过预防措施来预见并发症。间歇性雄激素抑制应谨慎考虑。密切随访将侧重于雄激素抑制不良反应的诊断。