Lichtman Stuart M, Wildiers Hans, Launay-Vacher Vincent, Steer Christopher, Chatelut Etienne, Aapro Matti
Memorial Sloan-Kettering Cancer Centre, New York, USA.
Eur J Cancer. 2007 Jan;43(1):14-34. doi: 10.1016/j.ejca.2006.11.004.
A SIOG taskforce was formed to discuss best clinical practice for elderly cancer patients with renal insufficiency. This manuscript outlines recommended dosing adjustments for cancer drugs in this population according to renal function. Dosing adjustments have been made for drugs in current use which have recommendations in renal insufficiency and the elderly, focusing on drugs which are renally eliminated or are known to be nephrotoxic. Recommendations are based on pharmacokinetic and/or pharmacodynamic data where available. The taskforce recommend that before initiating therapy, some form of geriatric assessment should be conducted that includes evaluation of comorbidities and polypharmacy, hydration status and renal function (using available formulae). Within each drug class, it is sensible to use agents which are less likely to be influenced by renal clearance. Pharmacokinetic and pharmacodynamic data of anticancer agents in the elderly are needed in order to maximise efficacy whilst avoiding unacceptable toxicity.
成立了国际老年肿瘤学会（SIOG）特别工作组，以讨论老年肾功能不全癌症患者的最佳临床实践。本手稿根据肾功能概述了该人群中癌症药物的推荐剂量调整。已对目前使用的、在肾功能不全和老年人中有相关推荐的药物进行了剂量调整，重点关注经肾脏消除或已知具有肾毒性的药物。如有可用的药代动力学和/或药效学数据，则以此为依据提出建议。特别工作组建议，在开始治疗前，应进行某种形式的老年医学评估，包括评估合并症和多种药物使用情况、水合状态和肾功能（使用可用公式）。在每个药物类别中，使用受肾脏清除影响较小的药物是明智的。需要了解老年患者中抗癌药物的药代动力学和药效学数据，以在避免不可接受毒性的同时最大化疗效。
