Radiothérapie du cancer de la prostate localisé chez le sujet âgé : l'hypofractionnement modéré est-il le traitement de référence ?

Radiation therapy technique and schedules could be adapted to patient's age because of a natural history of prostate cancer perceived as different, taking into account the comorbidities of patients but also a particular tolerance of elderly subjects. Thus, in localized prostate cancer, evaluation of associated diseases is essential before considering a treatment that will be of interest only if the life expectancy is greater than 10 years. When a curative approach is decided, radiotherapy holds a place of choice. Due to the recent results of randomized studies evaluating moderate hypofractionnated radiotherapy, showing a carcinological equivalence compared to a standard fractionation, this reduction in the duration of treatment appears particularly indicated in this elderly population. This approach permits to maintain the quality of life of patients, potentially with lower costs for society. The purpose of this article is to present the results of randomized trials of moderate hypofractionnation and discuss their application in the population of elderly patients with localized prostate cancer.