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首页> 外文期刊>Tumori. >Muscle-invasive bladder cancer in elderly-unfit patients with concomitant illness: can a curative radiation therapy be delivered?
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Muscle-invasive bladder cancer in elderly-unfit patients with concomitant illness: can a curative radiation therapy be delivered?

机译：患有老年疾病的伴有疾病的老年患者的肌肉浸润性膀胱癌：可以进行治愈性放射治疗吗？

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AIMS AND BACKGROUND: There is no standard treatment for elderly-unfit patients with muscle-invasive bladder cancer. Pelvic irradiation alone is an usual approach in this instance, and some reports have demonstrated that curative radiotherapy is feasible in elderly patients. To our knowledge, no data exist about the feasibility of a curative treatment in elderly patients with concomitant illness and a Charlson Comorbidity Index (an index of comorbidity that includes age) greater than 2. The main purpose of the present study was to establish the feasibility of irradiation in a cohort of elderly patients in poor general condition. METHODS: The records of 45 elderly-unfit patients (median age, 75 years; range, 70-85), with a comorbid Charlson score >2, treated with curative dose, planned continuous-course, external beam radiotherapy for muscle-invasive bladder cancer were reviewed. The patients were treated to a median total dose of 60 Gy (range, 56-64), with an average fractional dose of 190 +/- 10 cGy using megavoltage (6-15 MV). All patients were treated with radiation fields encompassing the bladder and grossly involved lymph nodes with a radiographic margin of at least 1.5 cm. RESULTS: No treatment-related mortality and clinically insignificant acute morbidity was recorded. No patient was hospitalized during or after the irradiation because of gastrointestinal or urogenital side effects. In one patient a week rest from therapy was necessary due a febrile status. Median survival was 21.5 months; overall 3- and 5-year survival was 36% and 19.5%, respectively. CONCLUSIONS: Elderly-unfit patients with comorbidities and >70 years of age can be submitted to radical pelvic irradiation. The results observed in this retrospective analysis have encouraged us to use non-palliative radiotherapy doses in these patients with muscle-invasive bladder cancer.
机译：目的和背景：对于患有肌肉浸润性膀胱癌的年老体弱患者，尚无标准治疗方法。在这种情况下，通常仅采用骨盆照射是可行的，一些报告表明，对老年患者进行放射治疗是可行的。据我们所知，尚无有关老年合并症患者中治愈性治疗的数据，并且Charlson合并症指数（包括年龄在内的合并症指数）大于2。本研究的主要目的是确定可行性一组一般状况较差的老年患者的放射治疗方法：记录45例老年人（中位年龄为75岁;范围为70-85），合并Charlson评分> 2，治愈剂量，计划连续疗程，外束放疗对肌浸润性膀胱疾病的影响癌症进行了审查。使用兆伏电压（6-15 MV），对患者进行了60 Gy（范围56-64）的中值总剂量治疗，平均分数剂量为190 +/- 10 cGy。所有患者均接受包括膀胱和严重累及的淋巴结在内的放射线治疗，放射线边缘至少为1.5 cm。结果：未记录到与治疗相关的死亡率和临床上无统计学意义的急性发病率。由于胃肠道或泌尿生殖系统的副作用，没有患者在放射期间或之后住院。在一名患者中，由于发热状态，必须每周休息一次治疗。中位生存期为21.5个月; 3年和5年总生存率分别为36％和19.5％。结论：患有合并症且年龄大于70岁的老年人，可以接受根治性盆腔放疗。回顾性分析中观察到的结果鼓励我们在这些患有肌肉浸润性膀胱癌的患者中使用非姑息性放疗剂量。

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