Phillips Tanyanika, Ji Jingran, Katheria Vani, Dale William
Department of Medical Oncology, City of Hope, Duarte, California, USA.
Center for Cancer and Aging, City of Hope, Duarte, California, USA.
J Am Geriatr Soc. 2025 Jul;73(7):2012-2018. doi: 10.1111/jgs.19361. Epub 2024 Dec 31.
Cancer and aging are inextricably linked, and older adults are a significant proportion of those diagnosed, treated, and living with and beyond a cancer diagnosis. Several large prospective studies have enhanced our understanding of how to improve the assessment, treatment, and outcomes of older adults with cancer starting therapy. This article summarizes three recent high-impact trials that produced practice-changing implications for the management of older adults with cancer that led to guideline updates. The key findings from these trials highlight that geriatric assessment-guided interventions in older adults with cancer: (1) facilitated higher rates of chemotherapy completion at planned doses with less modification among patients, (2) reduced grade 3 hematologic and non-hematologic toxicity during treatment delivery among patients of all stages of cancer receiving chemotherapy, and (3) influenced treatment decisions among advanced cancer patients receiving supportive care leading to reduced toxicity through reduced intensity of therapy without compromise of survival.
癌症与衰老有着千丝万缕的联系，在被诊断、治疗以及癌症诊断后仍存活甚至康复的人群中，老年人占了相当大的比例。几项大型前瞻性研究增进了我们对于如何改善老年癌症患者起始治疗的评估、治疗及治疗效果的理解。本文总结了三项近期具有重大影响的试验，这些试验对老年癌症患者的管理产生了改变实践的影响，进而促使指南更新。这些试验的关键发现表明，针对老年癌症患者的老年评估指导干预措施：（1）使患者按计划剂量完成化疗的比例更高，且化疗方案调整更少；（2）在接受化疗的所有癌症分期患者中，减少了治疗期间3级血液学和非血液学毒性；（3）影响了接受支持性治疗的晚期癌症患者的治疗决策，通过降低治疗强度减少了毒性，同时不影响生存率。
