Department of Medical Oncology, University General Hospital of Heraklion, Voutes, PO Box 1352, 71110 Heraklion, Greece.
Cancers (Basel). 2015 Mar 13;7(1):439-49. doi: 10.3390/cancers7010439.
Despite the high prevalence of colorectal cancer in a continuously aging population and the substantial advances in the treatment of metastatic disease during the past decade, the treatment of elderly patients with advanced, unresectable or metastatic colorectal cancer is a clearly unmet need. Since older patients are under-represented or even excluded from randomized trials, the evidence that oncologists use as guidance is weak. However, small prospective studies, pooled analyses and observational studies show that combination approaches are safe, efficacious and feasible in the geriatric population with metastatic colorectal cancer. The use of biologic agents targeting angiogenesis and the epidermal growth factor receptor, which have been shown to clearly improve outcomes in multiple prospective trials in patients with advanced colorectal cancer, is a vital component of the aforementioned combination approaches. Herein, we review all available data concerning the management of elderly patients with these agents and underscore the differences between this age subgroup and younger patients.
尽管在人口不断老龄化的情况下，结直肠癌的发病率很高，而且在过去十年中转移性疾病的治疗也取得了重大进展，但对于晚期、不可切除或转移性结直肠癌的老年患者的治疗仍然存在明显的未满足需求。由于老年患者在随机试验中代表性不足，甚至被排除在外，因此肿瘤学家作为指导依据的证据很薄弱。然而，小型前瞻性研究、汇总分析和观察性研究表明，联合治疗在转移性结直肠癌的老年人群中是安全、有效且可行的。针对血管生成和表皮生长因子受体的生物制剂的使用，已在多个晚期结直肠癌的前瞻性试验中明确改善了结果，这是上述联合治疗的重要组成部分。在此，我们回顾了所有关于这些药物治疗老年患者的可用数据，并强调了该年龄亚组与年轻患者之间的差异。
