Golfinopoulos Vassilis, Pentheroudakis George, Pavlidis Nicholas
School of Medicine, Department of Medical Oncology, University Hospital of Ioannina, GR-45110 Ioannina, Greece.
Cancer Treat Rev. 2006 Feb;32(1):1-8. doi: 10.1016/j.ctrv.2005.10.002. Epub 2005 Dec 5.
Although major progress has been achieved in the treatment of colorectal cancer, there are still several questions open for discussion concerning the management of elderly colorectal cancer patients. We conducted a review of the available literature concerning the use of adjuvant chemotherapy, palliative chemotherapy and surgery in elderly patients with colorectal cancer, using data from meta-analyses, non-systematic reviews and individual trials. All report similar survival benefits with adjuvant and palliative chemotherapy in elderly patients in comparison with younger age groups. Data on treatment-related side effects did not reveal a different toxicity profile for elderly patients. Efficacy and safety data were similar but more difficult to interpret concerning surgery, so this review is inconclusive about the proper use of this treatment modality in the elderly population. It is demonstrated that there is significant gain from chemotherapy in the adjuvant and palliative management of colorectal cancer patients irrespective of age. We, therefore, conclude that all patients should receive the most intensive treatment thought to be effective and safe, according to their biological age and comorbidities.
尽管在结直肠癌治疗方面已取得重大进展，但在老年结直肠癌患者的管理方面仍有几个问题有待讨论。我们利用荟萃分析、非系统综述和单项试验的数据，对有关老年结直肠癌患者辅助化疗、姑息化疗和手术应用的现有文献进行了综述。所有报告均显示，与年轻患者相比，老年患者接受辅助化疗和姑息化疗具有相似的生存获益。关于治疗相关副作用的数据并未显示老年患者有不同的毒性特征。手术的疗效和安全性数据相似，但更难解读，因此本综述对于该治疗方式在老年人群中的合理应用尚无定论。结果表明，无论年龄大小，化疗在结直肠癌患者的辅助和姑息治疗中均有显著获益。因此，我们得出结论，所有患者都应根据其生理年龄和合并症接受被认为有效且安全的最强化治疗。
