Conti J A, Christman K
Department of Medicine, Memorial Sloan-Kettering Cancer Center, Cornell University Medical College, New York, New York 10021, USA.
J Clin Gastroenterol. 1995 Jul;21(1):65-71.
Gastrointestinal malignancies are very common in the elderly of the U.S. There is controversy about the role of chemotherapy in these elderly patients because of the impression that this population experiences greater toxicity while deriving lesser benefit. Though definitive data is lacking regarding many aspects of chemotherapy in the elderly, some general observations can be made: (a) most chemotherapy agents do not have increased toxicity in the elderly; (b) dosing and regimen should be based more on functional parameters rather than chronologic age; (c) chemotherapy for advanced gastrointestinal malignancies is in general of marginal efficacy and can be potentially toxic, regardless of age; and (d) better prospective studies focusing on the efficacy, toxicity, and quality of life effects of chemotherapy in the elderly should be performed. We review the literature regarding chemotherapy pharmacology, efficacy, and organ-specific toxicity of agents used in gastrointestinal malignancies in the context of these principles.
胃肠道恶性肿瘤在美国老年人中非常常见。由于人们认为这一人群在化疗中获益较少而毒性更大，因此化疗在这些老年患者中的作用存在争议。尽管在老年人化疗的许多方面缺乏确切数据，但仍可得出一些一般性观察结果：(a) 大多数化疗药物在老年人中不会增加毒性；(b) 给药剂量和方案应更多地基于功能参数而非实际年龄；(c) 无论年龄如何，晚期胃肠道恶性肿瘤的化疗总体疗效有限且可能有毒性；(d) 应开展更完善的前瞻性研究，关注化疗对老年人疗效、毒性及生活质量的影响。我们依据这些原则综述了有关胃肠道恶性肿瘤化疗药理学、疗效及药物器官特异性毒性的文献。
