Division of Hematology-Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Curr Opin Oncol. 2012 Mar;24(2):130-6. doi: 10.1097/CCO.0b013e32834ea6ea.
Lung cancer is the leading cause of mortality in men and women, and the majority of patients with nonsmall cell lung cancer (NSCLC) are over 65 years of age. Treatment of elderly patients with NSCLC poses a significant therapeutic challenge owing to numerous pre-existing comorbidities, often-poor performance status and the increased risk of chemotherapy toxicities.
Single-agent chemotherapy is well tolerated, leads to an improvement in survival and quality of life outcomes and is favored by many clinicians in the treatment of elderly patients with NSCLC. Results from recent elderly specific randomized phase III trials and retrospective subgroup analyses of several trials have evaluated the use of combination chemotherapy in this difficult subgroup of patients, with encouraging results.
Elderly patients derive significant benefit from combination cytotoxic chemotherapy over single-agent chemotherapy. Therapeutic options for elderly patients include chemotherapy and/or targeted therapy, based on the individual tumor histology and molecular profile. As our population ages, it is critical we develop treatment strategies that are well tolerated , and which both minimize toxicity and maximize efficacy.
肺癌是男性和女性死亡的主要原因，大多数非小细胞肺癌（NSCLC）患者年龄超过 65 岁。由于存在许多合并症、通常较差的体能状态以及化疗毒性风险增加，老年 NSCLC 患者的治疗极具挑战性。
单药化疗耐受性良好，可改善生存和生活质量结果，并且许多临床医生在治疗老年 NSCLC 患者时都倾向于使用单药化疗。最近的几项专门针对老年患者的 III 期随机试验和回顾性亚组分析结果评估了联合化疗在这一困难患者亚组中的应用，结果令人鼓舞。
与单药化疗相比，老年患者从联合细胞毒性化疗中获益更多。老年患者的治疗选择包括化疗和/或靶向治疗，具体取决于个体肿瘤的组织学和分子特征。随着人口老龄化，我们必须制定出耐受良好的治疗策略，既要最大限度地降低毒性，又要最大限度地提高疗效。
