Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press66910.17650/1726-9776-2017-13-1-112-121PROSTATE CANCERРАК ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫDrug treatment opportunities of the elderly patients with the metastatic castration-resistant prostate cancerЛекарственные возможности лечения пожилых пациентов с метастатическим кастрационно-резистентным раком предстательной железыSolodkiyV. A.СолодкийВ. А.
Russian Federation
PavlovA. Yu.ПавловА. Ю.
Russian Federation
GafanovR. A.ГафановР. А.
Russian Federation

86 Profsoyuznaya St., Moscow 117485

Контакты: Рустем Айратович Гафанов 

117485 Москва, ул. Профсоюзная, 86

docgra@mail.ruGarmashS. V.ГармашС. В.
Russian Federation
KravtsovI. V.КравцовИ. Б.
Russian Federation
FastovetsS. V.ФастовецС. В.
Russian Federation
IvashinA. K.ИвашинА. К.
Russian Federation
Российский научный центр рентгенорадиологии3003201713111212104042017https://oncourology.abvpress.ru/oncur/article/view/669

Oncological disease in the elderly is a serious challenge to the patients health and medical staff. This is due to two main reasons. First, it is the general patient condition which weakened by the aging process, usually with the multiple co-morbidities, the second reason is conducted with multiple drugs therapy of intercurrent diseases. Most often, oncologists do not seek to prescribe anticancer drugs, and mainly it concerns chemotherapy, to patients of advanced age, fearing the excess toxicity leading to adverse effects. The age 70 years and over is that cut-off to determine the elderly patient with malignancy. If we take the cases of the metastatic castration-resistant prostate cancer (mCRPC) many, if not the majority, are the patients older than 70 years, as well significant the number of very elderly patients aged over 80 years. The presence of the various medicinal agents in medical arsenal can significantly prolong survival, including such patients. As a rule, in randomized trials, which studied the drugs for the mCRPC treatment, the elderly patients were not actively involved and it had some reason, related to comorbidity. In this review the available data on the elderly and very elderly patients with mCRPC who received the treatment within the clinical trials are considered. 

Онкологическое заболевание в пожилом возрасте – серьезная проблема для здоровья пациента и медицинского персонала. Это связано с 2 основными причинами: общим состоянием больного, ослабленного процессом старения, как правило, с несколькими сопутствующими патологиями и терапией интеркуррентных заболеваний, проводимой несколькими препаратами. Чаще всего врачи-онкологи стремятся не назначать противоопухолевые препараты (в основном это касается химиотерапии) больным преклонного возраста, опасаясь избыточной токсичности, приводящей к неблагоприятным последствиям. Возраст 70 лет и старше является отсечкой для определения пациента пожилого возраста со злокачественным новообразованием. Многие случаи метастатического кастрационно-резистентного рака предстательной железы (мКРРПЖ) регистрируются у больных старше 70 лет, также существенно число очень пожилых пациентов в возрасте старше 80 лет. Наличие различных лекарственных агентов в арсенале врачей может значительно увеличить выживаемость, в том числе таких больных. В рандомизированные исследования, в которых изучались препараты для лечения мКРРПЖ, пожилые пациенты, как правило, включались недостаточно активно в связи с коморбидностью. В данном обзоре рассматриваются имеющиеся данные о пожилых и очень пожилых пациентах с мКРРПЖ, которые получали лечение в рамках клинических исследований. 

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