Ferraresi Virginia, Vari Sabrina, Rossi Barbara, Maggi Gabriella, Giannarelli Diana, Persichetti Agnese, Petrongari Maria Grazia, Cercato Maria Cecilia, Annovazzi Alessio, Anelli Vincenzo, Pescarmona Edoardo, Baldi Jacopo, Zoccali Carmine, Pellegrini Domenicangela, Cognetti Francesco, Biagini Roberto
First Division of Medical Oncology, IRCCS-Regina Elena National Cancer Institute, 00161 Rome, Italy.
Oncological Orthopaedics Unit, IRCCS-Regina Elena National Cancer Institute, 00161 Rome, Italy.
J Clin Med. 2020 Aug 4;9(8):2503. doi: 10.3390/jcm9082503.
The high complexity of multimodality treatment frequently results in undertreatment of elderly sarcoma patients, and this may be one of the factors that influence their prognosis. We describe the real-life approach to a population of patients aged over 70 with both soft tissue (STS) and bone sarcomas (BS) followed by our Sarcoma Disease Management Team from 2012 to 2017. One-hundred and twenty-three patients with a median age of 77 years (range: 70-92) were identified. STS were the most common histological subtypes (94%) and the grade was high in 79/123 patients (64%). At diagnosis, 88% of patients had localized disease (LD) and 12% were metastatic (MD). Overall, 96% of patients with LD underwent surgery, 46/54 (85%) with high grade STS patients underwent complementary radiotherapy, and 10/54 (19%) received adjuvant treatments. Twelve out of 33 patients who relapsed (36%) underwent local therapies. Seventeen (52%) and eight (24%) patients were treated with first-line and second-line medical treatments, respectively. Tolerability to systemic treatments was fairly good. Overall, 21% of the patients with advanced disease were candidates for best supportive care alone. Our case series of elderly patients with both STS and BS shows that personalized multidisciplinary treatment can nevertheless be offered to this frail population in order to control the evolution of disease.
多模态治疗的高度复杂性常常导致老年肉瘤患者治疗不足，这可能是影响其预后的因素之一。我们描述了2012年至2017年期间，我们的肉瘤疾病管理团队对70岁以上软组织肉瘤（STS）和骨肉瘤（BS）患者群体采取的实际治疗方法。共确定了123例患者，中位年龄为77岁（范围：70 - 92岁）。STS是最常见的组织学亚型（94%），79/123例患者（64%）分级较高。诊断时，88%的患者为局限性疾病（LD），12%为转移性疾病（MD）。总体而言，96%的LD患者接受了手术，46/54例（85%）高级别STS患者接受了辅助放疗，10/54例（19%）接受了辅助治疗。33例复发患者中有12例（36%）接受了局部治疗。分别有17例（52%）和8例（24%）患者接受了一线和二线药物治疗。对全身治疗的耐受性相当好。总体而言，21%的晚期疾病患者仅适合接受最佳支持治疗。我们关于老年STS和BS患者的病例系列表明，尽管如此，仍可为这一脆弱群体提供个性化的多学科治疗，以控制疾病进展。
