[Urological cancers of the elderly subject: the role of radiotherapy]

Abstract

Urologic cancers are now usually found in elderly patients and the value of curative treatment is frequently asked. Life expectancy must not be underestimated with its consequence of undertreatment. Geriatric assessment is a good tool to make the right decision. For bladder and prostatic carcinomas, external beam radiation therapy is often the treatment of choice, if a curative option has been choose, because its toxicity is low in this population. In fact, many retrospectives studies have demonstrated that toxicity is equivalent in young and old patients. In prostate cancer, a recent randomised trial demonstrated that combination of irradiation and hormonal treatment increased biochemical control and overall survival over hormonal treatment alone. Hypofractionated schedules, more convenient to old patients, have been regularly reported for bladder cancers, but new techniques in radiation therapy seem to allow the use of this type of treatment schedules in prostate carcinomas.