Chen Qiang, Ying Shuo, Qin Jianwen, Zhang Li
Department of Respiratory and Critical Care Medicine, Tianjin Chest Hospital, Tianjin, China.
Department of Cardiology, Tianjin Chest Hospital, Tianjin, China.
Front Oncol. 2024 Jul 16;14:1384906. doi: 10.3389/fonc.2024.1384906. eCollection 2024.
Lung cancer stands as a malignant neoplasm bearing the highest burden of morbidity and mortality within the elderly population on a global scale. Among the lung cancer subtypes, non-small cell lung cancer (NSCLC) prevails as the most prevalent. As age advances, elderly patients often present with an increased prevalence of comorbidities, diminished organ reserve function, and alterations in drug pharmacokinetics, including absorption, distribution, metabolism, and clearance. These factors collectively contribute to a reduction in their capacity to tolerate therapeutic interventions. Regrettably, there exists a paucity of research data and evidence regarding the management of elderly patients afflicted by advanced lung cancer. This article endeavors to compile and elucidate strategies for the enhancement of treatment approaches, with the aim of aiding clinical decision-making. Prior to the selection of clinical treatment modalities for elderly patients with advanced NSCLC, a comprehensive assessment should be conducted, taking into account various facets, including tumor characteristics, patient age, physiological status, and the presence of comorbidities. The treatment strategy should be implemented in a tiered fashion, thereby affording the opportunity for the tailoring of individualized therapeutic approaches for elderly patients afflicted by advanced NSCLC. The demographic of elderly patients confronting advanced NSCLC presents a complex landscape marked by intricate underlying conditions, necessitating the imperative optimization of treatment strategies.
肺癌是全球老年人群中发病率和死亡率负担最高的恶性肿瘤。在肺癌亚型中,非小细胞肺癌(NSCLC)最为常见。随着年龄的增长,老年患者通常合并症患病率增加、器官储备功能下降以及药物药代动力学改变,包括吸收、分布、代谢和清除。这些因素共同导致他们耐受治疗干预的能力下降。遗憾的是,关于老年晚期肺癌患者管理的研究数据和证据匮乏。本文旨在汇编并阐明改善治疗方法的策略,以辅助临床决策。在为老年晚期NSCLC患者选择临床治疗方式之前,应进行全面评估,考虑肿瘤特征、患者年龄、生理状态和合并症等多个方面。治疗策略应分层实施,从而为老年晚期NSCLC患者量身定制个体化治疗方法提供机会。面临晚期NSCLC的老年患者群体情况复杂,存在复杂的基础疾病,因此必须优化治疗策略。