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老年人肺癌——21世纪日益严峻的流行病学问题。

Lung cancer in the elderly--increasing epidemiological problem of 21st century.

作者信息

Batura-Gabryel H, Foremska-Iciek J

机构信息

Department of Pulmonology Karol Marcinkowski University of Medical Sciences, Poznań, Poland.

出版信息

Rocz Akad Med Bialymst. 2005;50 Suppl 1:152-5.

Abstract

Lung cancer is the second most common malignant neoplasm after prostate and breast cancers. It is the most frequent cause of death related to neoplasms. The elderly people over 65, are the most numerous population suffering from lung cancer. Risk of incidence and death increases with aging process. In majority of patients, diagnose is established in highly advanced neoplastic process. More than 80% of all types of lung cancers make non-small cell lung cancer (NSCLC) and less than 20%--small cell lung cancer (SCLC). The choice of the managment must be individually considered and should be based on the stage of cancer clinical advance, clinical and functional status, concomitant diseases, nutritional status, cognitive functions. The patients age is not a contradiction for the introducement of the treatment. Surgical treatment is a method by choice at the early stages of NSCLC. Radical radiotherapy should be introduced in the elderly disqualified from the operation. Single-agent chemotherapy seems to be benficial for the elderly with advanced NSCLC in good general condition, mainly due to less toxicity and satisfactory the survival rate. In the cases of SCLC polychemotherapy with prophylactic brain radiation is the first-line managment. Unfortunately, the effectivity of the therapy is occupied by its toxicity. Still frequent occurrence and late diagnosis of lung cancer, high mortality, low efficiency of chemo- and radiotherapy causes the necessity of newer research for more effective screening methods, more effective and safer lung cancer treatment schemes for the elderly.

摘要

肺癌是继前列腺癌和乳腺癌之后第二常见的恶性肿瘤。它是与肿瘤相关的最常见死因。65岁以上的老年人是患肺癌人数最多的群体。发病率和死亡率风险随着衰老过程而增加。在大多数患者中,诊断是在肿瘤高度进展的阶段确立的。所有类型的肺癌中,超过80%为非小细胞肺癌(NSCLC),不到20%为小细胞肺癌(SCLC)。治疗方案的选择必须个体化考虑,应基于癌症临床进展阶段、临床和功能状态、伴随疾病、营养状况、认知功能。患者年龄并非进行治疗的禁忌。手术治疗是NSCLC早期的首选方法。对于不宜手术的老年人应采用根治性放疗。单药化疗似乎对一般状况良好的晚期NSCLC老年人有益,主要是因为毒性较小且生存率令人满意。在SCLC病例中,联合化疗加预防性脑放疗是一线治疗方法。不幸的是,治疗效果被其毒性所抵消。肺癌的频繁发生、晚期诊断、高死亡率以及化疗和放疗的低效率导致有必要开展更新的研究,以寻找更有效的筛查方法以及针对老年人更有效、更安全的肺癌治疗方案。

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