Division of Medical Oncology, National Cancer Centre Singapore, Singapore.
Medical Oncology Department, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France.
Lancet Oncol. 2018 Jun;19(6):e317-e326. doi: 10.1016/S1470-2045(18)30125-6. Epub 2018 Jun 1.
Therapy for metastatic renal cell carcinoma should be tailored to the circumstances and preferences of the individual patient. Age should not be a barrier to effective treatment. Systematic geriatric screening and assessment contributes to the goal of personalised management, in addition to the involvement of a multidisciplinary team. A task force from the International Society of Geriatric Oncology (SIOG) updated its 2009 consensus statement on the management of elderly patients with metastatic renal cell carcinoma by reviewing data from studies involving recently approved targeted drugs and immunotherapies for this disease. Overall, it seems that age alone does not appreciably affect efficacy. Among the pivotal studies that were included, there is a striking scarcity of analyses that relate toxic effects to patient age. Even if the adverse effects of therapy are no more frequent or severe in elderly patients than in their younger counterparts, the practical, psychological, and functional impact of treatment may be greater, especially if toxic effects are chronic and cumulative.
转移性肾细胞癌的治疗应根据个体患者的情况和偏好进行调整。年龄不应成为有效治疗的障碍。系统的老年病学筛查和评估有助于实现个体化管理的目标，此外还需要多学科团队的参与。国际老年肿瘤学会（SIOG）的一个工作组通过审查涉及最近批准的用于治疗这种疾病的靶向药物和免疫疗法的研究数据，更新了其 2009 年关于治疗转移性肾细胞癌老年患者的共识声明。总的来说，似乎年龄本身并不会显著影响疗效。在纳入的关键研究中，很少有分析将毒性作用与患者年龄相关联。即使治疗的不良反应在老年患者中不比年轻患者更频繁或更严重，但治疗的实际、心理和功能影响可能更大，特别是如果毒性作用是慢性和累积性的。
