Department of Medical Oncology, Flinders Medical Center, Bedford Park, South Australia 5042, Australia.
Cancer. 2013 Feb 15;119(4):722-8. doi: 10.1002/cncr.27802. Epub 2012 Sep 18.
Life expectancy is increasing, and more patients are presenting with cancer at an advanced age (≥80 years). Optimal management for this group of patients has not been well defined.
The South Australian Clinical Registry for Metastatic Colorectal Cancer (mCRC) collects data on all patients diagnosed since February 2006 in South Australia. The authors examined cancer characteristics, treatments administered, and outcomes for patients aged ≥80 years compared with patients aged <80 years.
Data from 2314 patients were evaluable, and 29.2% of these patients were aged ≥80 years. The majority had moderately differentiated tumors. Poorly differentiated tumors were reported in fewer patients aged ≥80 years (20.1% vs 26.1%; P < .005). Overall, 28.1% of patients aged ≥80 years received chemotherapy, and 74.2% received single-agent fluoropyrimidines as first-line treatment. By comparison, 68.2% of patients aged <80 years received chemotherapy, 74.3% received combination chemotherapy, and 25.7% received single-agent fluoropyrimidine as first-line treatment. No treatment was received by 38.2% of patients aged ≥80 years compared with 11.4% of those aged <80 years. Participation in clinical trials was lower in patients aged ≥80 years (2% vs 13%). The median survival was worse for patients aged ≥80 years (8.2 months vs 19.2 months; P < .001), and the median survival of patients who received chemotherapy was 19.0 months for those aged ≥80 years and 22.3 months for those aged <80 years (P = .139). Patients who did not receive treatment had a poor median survival regardless of age (2.6 months for patients aged ≥80 years vs 2.7 months for patients aged <80 years).
Patients aged ≥80 years were less likely to receive intervention for their metastatic colorectal cancer and had poorer survival. The survival of selected patients aged ≥80 years who received chemotherapy was similar to the survival of those aged <80 years despite the receipt of single-agent therapy. Patients aged ≥80 years with metastatic colorectal cancer are less likely to receive intervention for their disease and have poorer survival. Survival for selected patients aged ≥80 years who receive chemotherapy is similar to the survival of patients aged <80 years despite the receipt of single-agent therapy.
预期寿命在延长，越来越多的癌症患者在高龄（≥80 岁）时被诊断出来。目前尚未明确这一人群的最佳治疗方案。
南澳大利亚转移性结直肠癌临床登记处（mCRC）收集自 2006 年 2 月以来在南澳大利亚州诊断出的所有患者的数据。作者比较了年龄≥80 岁与<80 岁的患者的癌症特征、治疗方法和结局。
可评估的 2314 例患者中，有 29.2%的患者年龄≥80 岁。大多数患者的肿瘤分化程度为中度。年龄≥80 岁的患者中报告的低分化肿瘤较少（20.1%比 26.1%；<0.005）。总体而言，28.1%的年龄≥80 岁的患者接受了化疗，74.2%的患者接受了单药氟嘧啶作为一线治疗。相比之下，68.2%的年龄<80 岁的患者接受了化疗，74.3%的患者接受了联合化疗，25.7%的患者接受了单药氟嘧啶作为一线治疗。38.2%的年龄≥80 岁的患者未接受任何治疗，而年龄<80 岁的患者这一比例为 11.4%。年龄≥80 岁的患者参加临床试验的比例较低（2%比 13%）。年龄≥80 岁的患者中位生存期更差（8.2 个月比 19.2 个月；<0.001），接受化疗的患者中位生存期为年龄≥80 岁的 19.0 个月和年龄<80 岁的 22.3 个月（P=0.139）。无论年龄大小，未接受治疗的患者中位生存期均较差（年龄≥80 岁的患者为 2.6 个月，年龄<80 岁的患者为 2.7 个月）。
年龄≥80 岁的转移性结直肠癌患者接受治疗的可能性较低，且生存期较差。尽管接受了单药治疗，但年龄≥80 岁且接受化疗的选定患者的生存率与年龄<80 岁的患者相似。年龄≥80 岁的转移性结直肠癌患者接受疾病干预的可能性较低，且生存期较差。尽管接受了单药治疗，但年龄≥80 岁且接受化疗的选定患者的生存率与年龄<80 岁的患者相似。
