Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey.
Division of Medical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey.
Int J Radiat Oncol Biol Phys. 2018 Mar 15;100(4):926-944. doi: 10.1016/j.ijrobp.2017.12.261.
Rectal cancer predominantly affects patients older than 70 years, with peak incidence at age 80 to 85 years. However, the standard treatment paradigm for rectal cancer oftentimes cannot be feasibly applied to these patients owing to frailty or comorbid conditions. There are currently little information and no treatment guidelines to help direct therapy for patients who are elderly and/or have significant comorbidities, because most are not included or specifically studied in clinical trials. More recently various alternative treatment options have been brought to light that may potentially be utilized in this group of patients. This critical review examines the available literature on alternative therapies for rectal cancer and proposes a treatment algorithm to help guide clinicians in treatment decision making for elderly and comorbid patients.
直肠癌主要影响 70 岁以上的患者，发病高峰年龄为 80 至 85 岁。然而，由于虚弱或合并症，直肠癌的标准治疗方案通常不适用于这些患者。目前，对于年龄较大和/或患有严重合并症的患者，几乎没有信息和治疗指南来帮助指导治疗，因为大多数患者都没有被纳入或专门在临床试验中进行研究。最近，人们发现了各种替代治疗选择，这些选择可能会在这组患者中得到应用。这篇批判性综述检查了直肠癌替代疗法的现有文献，并提出了一个治疗算法，以帮助指导临床医生为老年和合并症患者做出治疗决策。
