Radiopharmaceuticals in the elderly cancer patient: Practical considerations, with a focus on prostate cancer therapy: A position paper from the International Society of Geriatric Oncology Task Force.

Détails

Ressource 1Télécharger: 1-s2.0-S0959804917307128-main.pdf (1101.69 [Ko])
Etat: Serval
Version: Final published version
ID Serval
serval:BIB_FA99950CEB70
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Editorial
Collection
Publications
Titre
Radiopharmaceuticals in the elderly cancer patient: Practical considerations, with a focus on prostate cancer therapy: A position paper from the International Society of Geriatric Oncology Task Force.
Périodique
European journal of cancer (Oxford, England : 1990)
Auteur(s)
Prior J.O., Gillessen S., Wirth M., Dale W., Aapro M., Oyen W.J.
ISSN
1879-0852 (Electronic)
ISSN-L
0959-8049
Statut éditorial
Publié
Date de publication
06/04/2017
Peer-reviewed
Oui
Volume
77
Pages
127-139
Langue
anglais
Notes
Publication types: Journal Article

Résumé
Molecular imaging using radiopharmaceuticals has a clear role in visualising the presence and extent of tumour at diagnosis and monitoring response to therapy. Such imaging provides prognostic and predictive information relevant to management, e.g. by quantifying active tumour mass using positron emission tomography/computed tomography (PET/CT). As these techniques require only pharmacologically inactive doses, age and potential frailty are generally not important. However, this may be different for therapy involving radionuclides because the radiation can impact normal bodily function (e.g. myelosuppression). Since the introduction of Iodine-131 as a targeted therapy in thyroid cancer, several radiopharmaceuticals have been widely used. These include antibodies and peptides targeting specific epitopes on cancer cells. Among therapeutic bone seeking agents, radium-223 ((223)Ra) stands out as it results in survival gains in patients with castration-resistant prostate cancer and symptomatic bone metastases. The therapeutic use of radiopharmaceuticals in elderly cancer patients specifically has received little attention. In elderly prostate cancer patients, there may be advantages in radionuclides' ease of use and relative lack of toxicity compared with cytotoxic and cytostatic drugs. When using radionuclide therapies, close coordination between oncology and nuclear medicine is needed to ensure safe and effective use. Bone marrow reserve has to be considered. As most radiopharmaceuticals are cleared renally, dose adjustment may be required in the elderly. However, compared with younger patients there is less, if any, concern about adverse long-term radiation effects such as radiation-induced second cancers. Issues regarding the safety of medical staff, care givers and the wider environment can be managed by current precautions.

Pubmed
Web of science
Open Access
Oui
Création de la notice
25/04/2017 17:57
Dernière modification de la notice
09/05/2019 3:48
Données d'usage