Trédaniel Jean, Savinelli Francesco, Sergent Guillaume, Bousquet Guilhem, Le Maignan Christine, Hennequin Christophe, Gossot Dominique, Misset Jean-Louis
Service d'oncologie médicale, Hôpital Saint-Louis, 1, avenue Claude Vellefaux, 75010 Paris, France.
Bull Cancer. 2008 May 28;95 FMC Onco:F57-64. doi: 10.1684/bdc.2007.0536.
Lung cancer is the leading cause of cancer-related death worldwide. The world population is getting increasingly older. The incidence of lung cancer is therefore growing among elderly patients. However, in spite of the universal recognition of the importance of clinical research to guide therapeutic decisions, elderly lung cancer patients are largely under-represented in cancer treatment trials. Age alone must not be a limiting factor in the choice of treatment. Indications for surgery should not vary with age. Fit elderly patients benefit from concurrent chemoradiotherapy. For metastatic patients, single-agent monotherapy with a third-generation agent (vinorelbine, gemcitabine or docetaxel) is the recommended option. Platinum-based chemotherapy may represent a valid option for fit elderly patients with adequate function. The role of the new biologic target-based agents is to be found. There is an absolute need of clinical trials specifically dedicated to elderly patients with lung cancer.
肺癌是全球癌症相关死亡的主要原因。世界人口正日益老龄化。因此,老年患者中肺癌的发病率正在上升。然而,尽管临床研究对指导治疗决策的重要性已得到普遍认可,但老年肺癌患者在癌症治疗试验中的代表性却很低。年龄本身不应成为治疗选择的限制因素。手术指征不应因年龄而异。身体状况良好的老年患者可从同步放化疗中获益。对于转移性患者,推荐使用第三代药物(长春瑞滨、吉西他滨或多西他赛)进行单药单一疗法。对于身体功能良好的老年患者,铂类化疗可能是一种有效的选择。新型生物靶向药物的作用有待发现。绝对需要专门针对老年肺癌患者的临床试验。