Cohen H J, Silberman H R, Forman W, Bartolucci A, Liu C
J Am Geriatr Soc. 1983 May;31(5):272-7. doi: 10.1111/j.1532-5415.1983.tb04870.x.
The elderly patient with malignancy is often considered a poor risk for treatment. To assess the effect of age on the treatment of one such disease, multiple myeloma (a disease with increased incidence in the elderly), a study was made of 280 patients treated with 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU), cyclophosphamide and prednisone on a Southeastern Cancer Study Group protocol. Initial response rates after six months of treatment were equivalent for the older compared with the younger age groups, with a slightly longer remission duration for those over 70. Likewise, survival was equivalent for the older patients. This was not the result of selection of older patients with less advanced disease, since the proportion with both good and poor risk factors are not significantly different in the various age groups. Moreover, for patients with each of the prognostic factors, older patients responded at least as well as younger patients. There were no significant differences among the age groups in gastrointestinal, skin, hair, or hematologic toxicity, although there was a slightly higher incidence of mild granulocyte and platelet toxicity in patients over 60. These findings are in contrast to the widely held belief that older patients cannot tolerate chemotherapy. On the contrary, they suggest that the elderly patient with myeloma may be expected to respond and survive, without excessive toxicity, at least as well as a younger counterpart with similar prognostic factors.
老年恶性肿瘤患者通常被认为治疗风险较高。为评估年龄对一种此类疾病（多发性骨髓瘤，一种在老年人中发病率增加的疾病）治疗的影响，对280例按照东南癌症研究组方案接受1,3 - 双（2 - 氯乙基）- 1 - 亚硝基脲（BCNU）、环磷酰胺和泼尼松治疗的患者进行了一项研究。治疗六个月后的初始缓解率在老年组与年轻组之间相当，70岁以上患者的缓解期略长。同样，老年患者的生存率也相当。这并非选择病情较轻的老年患者的结果，因为不同年龄组中具有良好和不良风险因素的比例并无显著差异。此外，对于具有每种预后因素的患者，老年患者的反应至少与年轻患者一样好。各年龄组在胃肠道、皮肤、毛发或血液学毒性方面无显著差异，尽管60岁以上患者轻度粒细胞和血小板毒性的发生率略高。这些发现与广泛持有的老年患者不能耐受化疗的观点相反。相反，它们表明老年骨髓瘤患者有望做出反应并存活，且毒性不过高，至少与具有相似预后因素的年轻患者一样。
