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Quimioterapia en pacientes de edad avanzada con cáncer de mama precoz: una revisión sistemática

Miriam Fernández-Pacheco^1,2,3, Michael Gerken⁴, Atanas Ignatov⁵

¹Department of Gynecology and Obstetrics, University Medical Center Regensburg, Regensburg, Germany. MFernandezPacheco@csj.de.

Archives of gynecology and obstetrics

|August 26, 2025

Resumen

Los beneficios de la quimioterapia (CHT) para pacientes de edad avanzada con cáncer de mama son inconsistentes. La evidencia sugiere que la TCC puede ayudar a las mujeres mayores sanas con cáncer de mama de alto riesgo, triple negativo o HER2-positivo.

Área de la Ciencia:

En el campo de la oncología
Medicina para la edad avanzada
Farmacología clínica

Sus antecedentes:

El cáncer de mama es común en pacientes de edad avanzada, que pueden recibir atención subóptima debido a comorbilidades y limitaciones de las directrices.
La evidencia de beneficio de la quimioterapia (CHT) en mujeres mayores con cáncer de mama es a menudo limitada.
Esta revisión examina la utilidad clínica de la TCC en pacientes de edad avanzada con cáncer de mama.

Objetivo del estudio:

Revisar sistemáticamente la evidencia sobre el beneficio clínico de la quimioterapia en mujeres de edad avanzada con cáncer de mama.
Evaluar el impacto de la TCC en la supervivencia y la toxicidad en esta población.
Identificar los factores que influyen en la eficacia de la TCC en pacientes de edad avanzada con cáncer de mama.

Principales métodos:

Se realizó una revisión sistemática de la literatura para los estudios publicados entre enero de 2000 y abril de 2023.
Las búsquedas incluyeron PubMed, centrándose en la aplicación de quimioterapia, los resultados de supervivencia y las toxicidades.
Veinticuatro estudios cumplieron con los criterios de inclusión para el análisis.

Principales resultados:

El beneficio de la terapia coronaria en pacientes de edad avanzada con cáncer de mama fue inconsistente.
La evidencia apoya el uso de CHT en pacientes mayores sanos con cáncer de mama de alto riesgo, incluidos los subtipos triple negativo o HER2-positivo.
Los datos sobre las tasas de disminución de la respuesta completa patológica (PCR) y la quimioterapia neoadyuvante (NACT) son controvertidos entre los grupos de edad.

Conclusiones:

La heterogeneidad en la definición de "anciano" y las variaciones en los regímenes de TCC limitan las conclusiones definitivas.
Las pacientes con cáncer de mama de alto riesgo pueden beneficiarse de la quimioterapia.
Se necesitan más investigaciones para las recomendaciones de tratamiento diferenciado en pacientes mayores con cáncer de mama.

Palabras clave:

Quimioterapia adyuvante Cáncer de mama Pacientes de edad avanzada Quimioterapia neoadyuvante

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