Currently, the elderly are defined by the following criteria: epidemiological studies are based on the age of 65 years; oncological studies are based on the age of 70 years. Older adults are at high risk for lung cancer and lung cancer is one of the leading causes of cancer deaths in the elderly. the incidence and mortality rates in the elderly population over 70 years of age have increased significantly over the past 10 years.
The current dilemma faced by elderly lung cancer patients.
1. are often excluded from clinical trials;
2. often receive unproven or inadequate treatment;
3. Treatment criteria are often established based on retrospective analysis only;
4.More clinical trials for older tumors are needed.
Treatment strategies for advanced elderly lung cancer include.
1.Two-drug combination chemotherapy with platinum-containing drugs;
2.Two-drug combination chemotherapy with non-platinum drugs;
3.Single agent chemotherapy;
4.Bio-targeted therapy;
5.Best supportive care without chemotherapy.
How to use the above treatment strategies reasonably in each elderly patient is a problem that every oncologist often faces. A large number of clinical studies have shown that: chemotherapy can prolong the survival and improve the quality of life of elderly lung cancer compared with best supportive care; combined chemotherapy has better efficacy than single agent chemotherapy; first-line biologic targeted therapy is selected according to mutations; and the prognosis of suitable elderly patients after appropriate treatment is comparable to that of non-elderly patients.
However, in clinical work, doctors often abandon chemotherapy because they are concerned about the ability of the elderly to tolerate chemotherapy, the efficacy of chemotherapy and so on. Families often have a hard time to choose because of this. Should chemotherapy be abandoned for the treatment of elderly patients with advanced lung cancer? The answer is: chemotherapy should not be abandoned!
As oncologists, we should conduct a comprehensive and careful evaluation of each elderly patient.
This includes.
1. the assessment of patient’s quality of life;
2. Assessment of the patient’s concomitant diseases;
3. Assessment of patient’s important organ function;
4. Assessment of the patient’s and family members’ willingness to treat. At the same time, we combine evidence-based medicine and follow the principles of standardized and individualized treatment to develop appropriate treatment plans for elderly lung cancer patients!