Gridelli C
Divisione di Oncologia Medica B, Istituto Nazionale Tumori, Via M. Semmola 3, 80131, Naples, Italy.
Crit Rev Oncol Hematol. 2000 Sep;35(3):219-25. doi: 10.1016/s1040-8428(99)00064-5.
In the last years there has been a growing awareness in the oncological community about the size of the problem of cancer in the elderly. More than 30% of lung cancers arise in patients aged 70 years or more. Elderly patients tolerate chemotherapy poorly and are not considered eligible for aggressive cisplatin based chemotherapy in clinical practice. A few papers have been published on chemotherapy of elderly NSCLC patients. Cisplatin based chemotherapy seems to be tolerated poorly. Vinorelbine as a single agent showed active and good tolerance. A phase III randomized trial, named ELVIS (Elderly Lung Cancer Vinorelbine Italian Study), showed a survival and quality of life benefit of vinorelbine versus supportive care. Among the new drugs gemcitabine can be considered more promising. Future trials should attempt to improve the results of vinorelbine chemotherapy and include geriatric and quality of life evaluations.
在过去几年中，肿瘤学界越来越意识到老年人癌症问题的规模。超过30%的肺癌发生在70岁及以上的患者中。老年患者对化疗耐受性差，在临床实践中不被认为适合进行以顺铂为基础的积极化疗。关于老年非小细胞肺癌患者化疗的文献已有一些发表。基于顺铂的化疗似乎耐受性较差。长春瑞滨作为单一药物显示出活性且耐受性良好。一项名为ELVIS（老年肺癌长春瑞滨意大利研究）的III期随机试验表明，与支持治疗相比，长春瑞滨可提高生存率和生活质量。在新药中，吉西他滨可被认为更有前景。未来的试验应试图改善长春瑞滨化疗的结果，并纳入老年医学和生活质量评估。
