摘要
在中国,肺癌的发病率和病死率均居恶性肿瘤的第一位。有近一半的肺癌发生在年龄大于70岁的老年患者。肺癌中约85%是非小细胞肺癌(non-small cell lung cancer,NSCLC),且大多数肺癌患者发现时已属中晚期。老年晚期NSCLC患者具有伴随疾病多、器官功能衰退等特点。制定恰当的治疗策略是我们面临的挑战。姑息治疗作为特殊的医疗关怀,是老年晚期NSCLC的重要治疗方式之一。低剂量局部姑息放疗可以有效改善老年NSCLC患者的呼吸道症状,且副作用可以耐受;对于表皮生长因子受体(epidermal growth factor receptor,EGFR)突变的老年晚期NSCLC,吉非替尼在疾病控制率、症状缓解等方面均可使老年患者从治疗中获益。同时,老年晚期NSCLC患者对厄洛替尼也显示出良好的耐受性;氩氦刀在治疗老年NSCLC患者的应用有增加趋势且患者对氩氦刀技术的耐受性和反应性都较好。中医药在改善临床症状、减少放化疗的毒副作用和提高生活质量方面有较好的疗效;社会心理支持疗法在一定程度上可缓解NSCLC患者的困扰,但其系统性有待完善。姑息治疗的评估和介入时机,是患者能否从中获益的重要因素。文章介绍了老年NSCLC姑息治疗获益研究的进展,为老年NSCLC的姑息治疗提供依据。
Lung cancer is the leading cause of death among all cancers in China. It also has the highest incidence when compared to other cancers. Almost half of all lung cancers occur over 70-year-old. Approximately 85% of all lung cancers are non-small cell lung cancer （NSCLC）. The majority of patients are advanced lung cancer. Due to the unique alterations in physiology, elderly patients are at a greater risk of toxicity from chemotherapy. Palliative care as a special medical care is an important treatment for elderly patients with advanced NSCLC. Low-dose palliative radiotherapy can improve respiratory symptoms in elderly patients with NSCLC, with the tolerated side effects. Elderly patients with epidermal growth factor receptor （EGFR） mutation can benefit from gefitinib and have a good tolerate of erlotiib. Cryocare Surgical System has an increasing trend of application in the treatment of elderly patients with NSCLC. Chinese medicine has effects in improving clinical symptoms and reducing side effects of chemotherapy, it can also improve the quality of life in these patients. Psychosocial support therapy can alleviate the burden of patients with NSCLC to some extent, but needs to improve its systematicness. Assessment and the time of palliative care are two important factors which determine the outcome of patients. We introduce the progress in palliative care benefit of elderly NSCLC, in order to provide the basis for palliative care of elderly NSCLC.
出处
《中国肺癌杂志》
CAS
CSCD
北大核心
2015年第7期462-468,共7页
Chinese Journal of Lung Cancer
关键词
肺肿瘤
老年肿瘤
姑息治疗
Lung neoplasms
Elderly cancer
Palliative care
