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Challenges and advances in cervix cancer treatment in elder women.
Cancer Treatment Reviews ( IF 9.6 ) Pub Date : 2020-01-23 , DOI: 10.1016/j.ctrv.2020.101976
M Kissel 1 , A Rambeau 2 , S Achkar 1 , F Lecuru 3 , P Mathevet 4
Affiliation  

With population ageing, cancer treatments in elder patients is becoming a true public health care issue. There is an authentic dilemma between patient's frailty, residual life expectancy and the toll that take anticancer treatments. Since elder patients are almost always excluded from clinical trials, it is hard to get robust scientific data on the tolerability of oncologic treatments and to set in place recommendations. Cervix cancer is traditionally diagnosed in younger women but it has a 2nd incidence peak between 60 and 70 years old. Cervix cancer in elder patients is a subject to many questions in terms of screening and is a therapeutic challenge. This article reviews literature data on these different aspects, from screening to surgery, from radiotherapy to brachytherapy, from chemotherapy to supportive care, from immunotherapy to geriatric assessment. We tried to show how modern therapeutic innovations may benefit elder patients. Expected benefits in terms of efficacy and toxicity may overcome the long-lasting tendency to undertreatment in elder patients and improve their quality of life after cancer treatment. In 2020, there seems to be less and less reasons justifying that elder women with cervix cancer may not receive the appropriate treatment.

中文翻译:

老年妇女宫颈癌治疗的挑战和进展。

随着人口老龄化,老年患者的癌症治疗已成为真正的公共卫生保健问题。患者的虚弱,剩余寿命与采取抗癌治疗的费用之间存在真正的两难选择。由于老年患者几乎总是被排除在临床试验之外,因此很难获得有关肿瘤治疗耐受性的可靠科学数据并难以提出建议。传统上,宫颈癌是在年轻女性中诊断出来的,但其发病率在60至70岁之间是第二高的。在筛查方面,老年患者的宫颈癌是许多问题,是治疗上的挑战。本文回顾了有关这些不同方面的文献数据,从筛查到手术,从放疗到近距离放射治疗,从化学疗法到支持治疗,从免疫疗法到老年评估。我们试图证明现代治疗创新如何使老年患者受益。就功效和毒性而言,预期的益处可能会克服老年患者长期接受治疗不足的趋势,并改善癌症治疗后的生活质量。在2020年,似乎越来越少的理由证明老年宫颈癌妇女可能得不到适当的治疗。
更新日期:2020-01-23
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