Carreca Ignazio, Balducci Lodovico
University of Palermo School of Medicine, Palermo, Italy.
Urol Oncol. 2009 Nov-Dec;27(6):633-42. doi: 10.1016/j.urolonc.2009.08.006.
This article reviews the principles of systemic cancer treatment in older individuals. These include: assessment of physiologic age with a comprehensive geriatric assessment (CGA), adjustment of chemotherapy doses to the patient's renal function, and prevention of myelotoxicity with hemopoietic growth factors. Other complications that become more common with age include mucositis, peripheral neuropathy and cardiomyopathy. Two chronic complications of chemotherapy become more common with age, including myelodysplasia and chronic cardiomyopathy. The goal of systemic cancer treatment in the older person should include prolongation of active life-expectancy and compression of morbidity in addition to prolongation of survival and symptom management.
本文综述了老年个体系统性癌症治疗的原则。这些原则包括:通过全面老年评估(CGA)评估生理年龄,根据患者肾功能调整化疗剂量,以及使用造血生长因子预防骨髓毒性。随着年龄增长更常见的其他并发症包括粘膜炎、周围神经病变和心肌病。化疗的两种慢性并发症随着年龄增长更为常见,包括骨髓增生异常和慢性心肌病。老年患者系统性癌症治疗的目标除了延长生存期和症状管理外,还应包括延长积极预期寿命和缩短发病期。