优化老年晚期非小细胞肺癌患者的治疗策略

Qiang Chen, Shuo Ying, Jianwen Qin, Li Zhang
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摘要

肺癌是全球老年人发病率和死亡率最高的恶性肿瘤。在肺癌亚型中,非小细胞肺癌(NSCLC)的发病率最高。随着年龄的增长,老年患者往往合并症增多,器官储备功能减退,药物药代动力学(包括吸收、分布、代谢和清除)发生改变。这些因素共同导致患者耐受治疗干预的能力下降。遗憾的是,有关晚期肺癌老年患者治疗的研究数据和证据十分匮乏。本文试图梳理和阐明加强治疗方法的策略,以帮助临床决策。在为晚期 NSCLC 老年患者选择临床治疗方法之前,应进行全面评估,考虑肿瘤特征、患者年龄、生理状态和是否存在合并症等多方面因素。治疗策略应分层实施,从而为晚期 NSCLC 老年患者提供量身定制个体化治疗方法的机会。晚期 NSCLC 老年患者的基本情况错综复杂,因此必须优化治疗策略。
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Optimization of treatment strategies for elderly patients with advanced non-small cell lung cancer
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.
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