Lichtman Stuart M, Wildiers Hans, Chatelut Etienne, Steer Christopher, Budman Daniel, Morrison Vicki A, Tranchand Brigitte, Shapira Iuliana, Aapro Matti
Memorial Sloan-Kettering Cancer Center, Commack, New York 11725, USA.
J Clin Oncol. 2007 May 10;25(14):1832-43. doi: 10.1200/JCO.2007.10.6583.
The elderly comprise the majority of patients with cancer and are the recipients of the greatest amount of chemotherapy. Unfortunately, there is a lack of data to make evidence-based decisions with regard to chemotherapy. This is due to the minimal participation of older patients in clinical trials and that trials have not systematically evaluated chemotherapy. This article reviews the available information with regard to chemotherapy and aging provided by a task force of the International Society of Geriatric Oncology (SIOG). Due to the lack of prospective data, the conclusions and recommendations made are a consensus of the participants. Extrapolation of data from younger to older patients is necessary, particularly to those patients older than 80 years, for which data is almost entirely lacking. The classes of drugs reviewed include alkylators, antimetabolites, anthracyclines, taxanes, camptothecins, and epipodophyllotoxins. Clinical trials need to incorporate an analysis of chemotherapy in terms of the pharmacokinetic and pharmacodynamic effects of aging. In addition, data already accumulated need to be reanalyzed by age to aid in the management of the older cancer patient.
老年患者占癌症患者的大多数，也是接受化疗最多的人群。不幸的是，缺乏数据来做出关于化疗的循证决策。这是由于老年患者在临床试验中的参与度极低，且试验并未系统地评估化疗。本文回顾了国际老年肿瘤学会（SIOG）一个特别工作组提供的关于化疗与衰老的现有信息。由于缺乏前瞻性数据，所得出的结论和建议是参与者的共识。有必要将年轻患者的数据外推至老年患者，尤其是80岁以上的数据几乎完全缺失的患者。所审查的药物类别包括烷化剂、抗代谢物、蒽环类、紫杉烷类、喜树碱类和鬼臼毒素类。临床试验需要纳入对化疗在衰老的药代动力学和药效学方面影响的分析。此外，已积累的数据需要按年龄重新分析，以辅助老年癌症患者的管理。
