Cancers de prostate : quelle place pour la radiothérapie à visée curative chez les patients âgés ?

Purpose: Discuss the place of radiotherapy given in a curative intent in elderly patients with localised prostate cancer according to complications, local control, survival observed in a specific and a review of the literature. Patients and methods: The cohort consisted of 65 males aged 80 or more with localised prostate cancer who choose radiotherapy as a curative modality. Twelve radiotherapy centres affiliated to the Rare Cancer Network participated to the study. The retrospective analysis was carried out on immediate and late side-effects, biological free of relapse survival and global survival. Multivariate analysis took into account the comorbidities, the initial prostatic specific antigen (PSA) value, the Gleason score and the therapeutic modalities. Results: From January 1990 to December 2000, 65 patients were included into the cohort. Mean age was 81 years. The specific series consisted of 10 T1, 40 T2 and 15 T3 N0M0. Median follow up was 65 months. Immediate and late complications were comparable to those described in younger patients who received a similar irradiation. There were no negative impact of the treatment on disease free survival and global survival. Recent literature did suggest analogous results. Conclusions: Radiation therapy with a curative intent should not be systematically withheld in elderly patients with localised prostate cancer.