Administration of chemotherapy in prostate cancer depends on patient fitness. In unfit patients, physiological impairment determines the optimum treatment. Although no consensus on assessing patient fitness currently exists, this article proposes an algorithm combining the available information for administering chemotherapy, and in particular docetaxel, in unfit patients. It was constructed by reviewing factors that can influence treatment, such as performance status, taxane-related comorbidities and nutritional status. Geriatric scales for prostate cancer patients and alternative treatment regimens for this population are also reviewed. In summary, patients require overall assessment to optimise treatment. Use of docetaxel should be restricted in unfit patients, and other options must be evaluated, because of high toxicity and low efficacy.
Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico. 2018 Jul 26 [Epub ahead of print]
U Anido-Herranz, N Fernández-Núñez, J Afonso-Afonso, L Santomé-Couto, A Medina-Colmenero, O Fernández-Calvo, M Lázaro-Quintela, S Vázquez
Medical Oncology Department, Santiago University Hospital Complex (CHUS), Travesía de Coupana, s/n, 15706, Santiago de Compostela, Spain. ., Medical Oncology Department, Lucus Augusti University Hospital (HULA), Lugo, Spain., Medical Oncology Department, El Ferrol University Hospital Complex (CHUF), Ferrol, Spain., Medical Oncology Department, POVISA Hospital, Vigo, Spain., Medical Oncology Department, Centro Oncológico de Galicia, A Coruña, Spain., Medical Oncology Department, Ourense University Hospital Complex, Orense, Spain., Medical Oncology Department, Vigo University Hospital Complex (CHUVI), Vigo, Spain.