دورية أكاديمية
Lung cancer in the elderly.
| العنوان: | Lung cancer in the elderly. |
|---|---|
| المؤلفون: | Gridelli C; Division of Medical Oncology, S.G. Moscati Hospital, Avellino, Italy. cgridelli@libero.it, Langer C, Maione P, Rossi A, Schild SE |
| المصدر: | Journal of clinical oncology : official journal of the American Society of Clinical Oncology [J Clin Oncol] 2007 May 10; Vol. 25 (14), pp. 1898-907. |
| نوع المنشور: | Journal Article; Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Society of Clinical Oncology Country of Publication: United States NLM ID: 8309333 Publication Model: Print Cited Medium: Internet ISSN: 1527-7755 (Electronic) Linking ISSN: 0732183X NLM ISO Abbreviation: J Clin Oncol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2003- : Alexandria, VA : American Society of Clinical Oncology Original Publication: New York, N.Y. : Grune & Stratton, c1983- |
| مواضيع طبية MeSH: | Aged*, Carcinoma, Non-Small-Cell Lung/*drug therapy , Carcinoma, Non-Small-Cell Lung/*radiotherapy , Lung Neoplasms/*drug therapy , Lung Neoplasms/*radiotherapy, Antineoplastic Agents/adverse effects ; Antineoplastic Agents/therapeutic use ; Carcinoma, Non-Small-Cell Lung/pathology ; Chemotherapy, Adjuvant ; Clinical Trials as Topic ; Combined Modality Therapy ; Comorbidity ; Humans ; Lung Neoplasms/pathology ; Patient Selection ; Radiotherapy, Adjuvant |
| مستخلص: | Purpose: Elderly patients often have comorbidities and other characteristics that make the selection of treatment daunting. Methods: We have reviewed the available evidence in the literature to gauge the results of therapy for elderly lung cancer patients. Results: The beneficial results achieved with adjuvant chemotherapy in the general population with early non-small-cell lung cancer (NSCLC) cannot be automatically extrapolated to the elderly, who are at higher risk of toxicity. Retrospective analyses of combined chemoradiotherapy in locally advanced NSCLC patients suggest equivalent therapeutic benefit for younger and older patients, despite heightened toxicity. There have been no elderly-specific phase III trials for locally advanced NSCLC. For advanced NSCLC, on the basis of evidence-based data, single-agent chemotherapy remains the standard of care for nonselected elderly patients. However, retrospective analyses suggest that the efficacy of platinum-based combination chemotherapy is similar in fit older and younger patients, with increased but acceptable toxicity for elderly patients. In limited-disease small-cell lung cancer (SCLC), sequential chemoradiotherapy is clearly less toxic compared with a standard concurrent approach, but our assessment of treatment is hindered by the absence of prospective elderly-specific trials. Although prophylactic cranial irradiation has emerged as a standard strategy, it should be omitted in patients with cognitive impairment. In extensive SCLC, etoposide in combination with either cisplatin or carboplatin has emerged as standard treatment; hematopoietic support may be necessary. Conclusion: With the exception of advanced NSCLC, prospective elderly-specific studies are lacking. Available data suggest that outcomes in the fit elderly mirror results observed in younger patients, although toxicity is generally worse. |
| Number of References: | 92 |
| المشرفين على المادة: | 0 (Antineoplastic Agents) |
| تواريخ الأحداث: | Date Created: 20070510 Date Completed: 20070605 Latest Revision: 20071115 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1200/JCO.2006.10.3085 |
| PMID: | 17488989 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1527-7755 |
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| DOI: | 10.1200/JCO.2006.10.3085 |