Sanoff Hanna Kelly, Bleiberg Harry, Goldberg Richard M
Department of Medicine, Division of Hematology-Oncology, University of North Carolina at Chapel Hill, NC 27599, USA.
J Clin Oncol. 2007 May 10;25(14):1891-7. doi: 10.1200/JCO.2006.10.1220.
Colorectal cancer (CRC) is predominantly a disease of older persons, and our population is aging. Physicians and their older patients commonly face the dilemma of whether or not to give/receive systemic chemotherapy for CRC. Evidence supports the safety and efficacy of systemic chemotherapy in fit older patients motivated enough to enroll onto clinical trials. Conversely, frail older patients are more likely to suffer adverse outcomes when faced with stressors and may not benefit from chemotherapy. However, the majority of patients are neither fit nor frail, and current evidence is insufficient to either quantify or qualify the benefit of chemotherapy for this intermediate group of patients. Thus, treatment decisions must be individualized based on each older person's physical state (eg, their function and degree of comorbidity) and values. Despite a growing body of data, a great deal of work is still needed to establish optimal strategies to care for patients diagnosed with cancer later in life.
结直肠癌（CRC）主要是一种老年人疾病，而且我们的人口正在老龄化。医生及其老年患者通常面临是否对CRC进行全身化疗的两难困境。有证据支持全身化疗对有足够积极性参加临床试验的健康老年患者的安全性和有效性。相反，体弱的老年患者在面对压力源时更有可能出现不良后果，并且可能无法从化疗中获益。然而，大多数患者既不属于健康人群也不属于体弱人群，目前的证据不足以量化或界定化疗对这一中间群体患者的益处。因此，治疗决策必须根据每个老年人的身体状况（例如他们的功能和合并症程度）和价值观进行个体化。尽管数据越来越多，但仍需要大量工作来建立照顾晚年被诊断患有癌症患者的最佳策略。
