Vallet-Regí María, Manzano Miguel, Rodriguez-Mañas Leocadio, Checa López Marta, Aapro Matti, Balducci Lodovico
Departamento de Química Inorgánica y Bioinorgánica, Facultad de Farmacia, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Hospital, 12 de Octubre i+12, Madrid, Spain
Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain.
Oncologist. 2017 Mar;22(3):335-342. doi: 10.1634/theoncologist.2016-0276. Epub 2017 Feb 20.
The management of cancer in older aged people is becoming a common problem due to the aging of the population. There are many variables determining the complex situation that are interconnected. Some of them can be assessed, such as risk of mortality and risk of treatment complications, but many others are still unknown, such as the course of disease, the host-related factors that influence cancer aggressiveness, and the phenotype heralding risk of permanent treatment-related damage.This article presents a dynamic and personalized approach to older people with cancer based on our experience on aging, cancer, and their biological interactions. Also, novel treatments and management approaches to older individuals, based on their functional age and their social and emotional needs, are thoughtfully explored here. 2017;22:335-342 IMPLICATIONS FOR PRACTICE: The goal of this article is to suggest a practical approach to complexity, a clinical situation becoming increasingly common with the aging of the population. Beginning with the analysis of two clinical cases, the authors offer an algorithm for approaching cancer in the older person that involves the assessment of life expectancy without cancer, the risk that cancer might compromise a patient's survival, function, or quality of life, and the potential benefits and risks of the treatments based on a clinical evaluation. The authors then review possible laboratory assessment of functional age and the importance of rapid-learning databases in the study of cancer and age.
由于人口老龄化，老年癌症患者的管理正成为一个普遍问题。有许多相互关联的变量决定着这一复杂情况。其中一些可以评估，如死亡风险和治疗并发症风险，但许多其他因素仍然未知，如疾病进程、影响癌症侵袭性的宿主相关因素以及预示永久性治疗相关损害风险的表型。本文基于我们在衰老、癌症及其生物相互作用方面的经验，提出了一种针对老年癌症患者的动态个性化方法。此外，还在此深入探讨了基于老年个体功能年龄及其社会和情感需求的新型治疗方法和管理策略。2017年；22卷：335 - 342页 对实践的启示：本文的目的是提出一种应对复杂性的实用方法，随着人口老龄化，这种临床情况越来越普遍。作者从分析两个临床病例入手，提供了一种针对老年癌症患者的算法，该算法涉及评估无癌症情况下的预期寿命、癌症可能危及患者生存、功能或生活质量的风险，以及基于临床评估的治疗潜在益处和风险。作者随后回顾了功能年龄可能的实验室评估以及快速学习数据库在癌症与年龄研究中的重要性。
