Saif Muhammad W, Lichtman Stuart M
Yale University School of Medicine, Section of Medical Oncology, 333 Cedar Street, FMP 116, New Haven, CT 06520, USA.
Crit Rev Oncol Hematol. 2009 Nov;72(2):155-69. doi: 10.1016/j.critrevonc.2009.02.006. Epub 2009 Apr 7.
The majority of patients with colorectal cancer (CRC) are >/=65 years of age, yet older patients with CRC remain under-represented in clinical trials. Older adult patients may be more likely than younger patients to experience chemotherapy-related toxicities due to factors such as existing comorbidities, incompatibility of chemotherapy with other medications, and age-related reduction in the detoxification and elimination potential of the liver and kidneys. However, the older patient group are a heterogeneous population. The available data on treatment of older patients with CRC indicate that fit older adult patients have the potential to derive the same benefit as do younger patients. A comprehensive geriatric assessment can help to identify patients most likely to benefit from standard treatment. In this review, we will evaluate the chemotherapy regimens investigated in older adult patients with CRC, and how the safety profiles and efficacy of chemotherapy in the older adult compare with those observed in younger patients.
大多数结直肠癌(CRC)患者年龄≥65岁,但老年CRC患者在临床试验中的代表性仍然不足。由于存在合并症、化疗与其他药物不相容以及与年龄相关的肝脏和肾脏解毒及清除能力下降等因素,老年患者可能比年轻患者更容易出现化疗相关毒性。然而,老年患者群体是一个异质性群体。关于老年CRC患者治疗的现有数据表明,健康的老年患者有可能获得与年轻患者相同的益处。全面的老年综合评估有助于识别最有可能从标准治疗中获益的患者。在本综述中,我们将评估在老年CRC患者中研究的化疗方案,以及老年患者化疗的安全性和疗效与年轻患者相比情况如何。