Won Elizabeth, Ilson David H
Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Oncologist. 2014 Apr;19(4):367-74. doi: 10.1634/theoncologist.2013-0178. Epub 2014 Mar 24.
Most patients with gastroesophageal cancers are older than 65 years of age. The management of older patients poses challenges because they have multiple comorbidities and physiological changes associated with aging. Furthermore, data are limited on tolerance of cancer therapy and the use of combined-modality treatments in this patient population to guide their treatment. In this article, we focus on the management of older patients with localized esophageal cancer, highlighting the role of comprehensive geriatric assessment to identify and better tailor treatment approaches in this patient population. We review the literature and discuss the role of surgical resection and potential complications specific to an older patient. We review the rationale of combined-modality treatment and the potential benefits of a chemoradiotherapy-based approach in this patient population.
大多数食管癌和胃癌患者年龄在65岁以上。老年患者的治疗面临挑战，因为他们有多种合并症以及与衰老相关的生理变化。此外，关于该患者群体对癌症治疗的耐受性以及联合治疗方法的应用的数据有限，难以指导其治疗。在本文中，我们重点关注老年局限性食管癌患者的治疗，强调综合老年评估在识别和更好地定制该患者群体治疗方法方面的作用。我们回顾文献并讨论手术切除的作用以及老年患者特有的潜在并发症。我们还回顾了联合治疗的基本原理以及基于放化疗方法在该患者群体中的潜在益处。
