Servagi Vernat S, Guilbert P, Bouché G, Ramiandrisoa F, Bellefqih S
Département d'oncologie radiothérapie, institut de cancérologie Jean-Godinot, 1, rue du Général Koenig, 51726 Reims cedex, France.
Département d'oncologie radiothérapie, institut de cancérologie Jean-Godinot, 1, rue du Général Koenig, 51726 Reims cedex, France.
Cancer Radiother. 2018 Oct;22(6-7):644-646. doi: 10.1016/j.canrad.2018.07.130. Epub 2018 Aug 27.
Rectal cancer is a common pathology in the elderly. The standard for advanced rectal tumors is a chemoradiotherapy regimen combined 50Gy with concomitant chemotherapy followed by a surgery. This treatment induces interruptions of chemoradiotherapy and toxicities G3-4 more important in people over 70 years of age. Hypofractionated radiotherapy 5×5Gy with surgery following week is an alternative. All retrospective studies on this fractionation report an excellent immediate and chronic tolerance. The randomized phase III NACRE trial, comparing these 2 radiotherapy, followed by surgery at 6-8 week, established a standard in the management of the elderly patients.
直肠癌是老年人常见的病理类型。晚期直肠肿瘤的标准治疗方案是同步放化疗,剂量为50Gy并联合化疗,随后进行手术。这种治疗会导致放化疗中断,且在70岁以上人群中3-4级毒性反应更为严重。大分割放疗方案(5次,每次5Gy),随后在下周进行手术是一种替代方案。所有关于这种分割方式的回顾性研究均报告了良好的即刻耐受性和长期耐受性。随机III期NACRE试验比较了这两种放疗方式,随后在6-8周时进行手术,为老年患者的治疗确立了标准。