Treatment of colorectal cancer in the elderly
Treatment of colorectal cancer in the elderly
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DOI：
10.4251/wjgo.v7.i10.204
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发表时间：
2015-10-15
影响因子：
3
通讯作者：
Francesch, Tani
中科院分区：
文献类型：
--
作者：
Millan, Monica;Merino, Sandra;Francesch, Tani
结直肠癌的发病率很高，大约60%的结直肠癌患者年龄超过70岁，在不久的将来，这一发病率可能会增加。老年患者（> 70-75岁）是一个非常异质的群体，从非常健康到非常虚弱。传统上，这些患者往往治疗不足，招募临床试验的频率低于年轻患者，因此在癌症治疗的出版物中代表性不足。最近的研究表明，健康的老年患者可以像年轻患者一样接受治疗，但对合并症的虚弱患者的治疗仍然存在争议。应考虑许多因素，包括适合治疗，患者和家人的愿望，以及生活质量。本综述将重点关注70岁以上结直肠癌患者的手术、肿瘤学和姑息治疗的现有证据。仔细的病人评估是必要的，以个性化的治疗方法，这应该依赖于一个多学科的过程。在这一患者人群中需要更多设计良好的对照试验。
Colorectal cancer has a high incidence, and approximately 60% of colorectal cancer patients are older than 70, with this incidence likely increasing in the near future. Elderly patients (> 70-75 years of age) are a very heterogeneous group, ranging from the very fit to the very frail. Traditionally, these patients have often been under-treated and recruited less frequently to clinical trials than younger patients, and thus are under-represented in publications about cancer treatment. Recent studies suggest that fit elderly patients can be treated in the same way as their younger counterparts, but the treatment of frail patients with comorbidities is still a matter of controversy. Many factors should be taken into account, including fitness for treatment, the wishes of the patient and family, and quality of life. This review will focus on the existing evidence for surgical, oncologic, and palliative treatment in patients over 70 years old with colorectal cancer. Careful patient assessment is necessary in order to individualize treatment approach, and this should rely on a multidisciplinary process. More well-designed controlled trials are needed in this patient population.