老年结直肠癌的治疗

Colorectal Treatment in Older Patients

老年患者占结直肠癌患者的70%,因此老年人是结直肠癌的主要患病人群。为了提高结直肠癌治疗的总体疗效,我们应当特别关注老年性结直肠癌的治疗。以往,手术治疗和化疗的应用随着年龄的增高而明显减少。我们一直以为老年人手术和化疗的效果不令人满意。近期的研究改变了这一认识。证据表明辅助化疗和姑息性化疗对一般情况良好的老年人是有效而安全的。即使存在一些与年龄相关的基础疾病的老年结直肠癌患者仍然能从合理的治疗方案中获益。所以我们尚有许多工作需做,以提高老年性结直肠癌患者的疗效。腹腔镜下结肠癌根治术是对老年人安全有效的手术技术。我们期待随着经腔道的内窥镜手术技术的发展,将来会使老年性结直肠癌患者受益。

Colorectal cancer （CRC） is predominantly a disease of older persons, who make up more than 70% of CRC patients. To improve the outcomes of CRC, we should pay more attention to the treatment of older patients. As we know, both surgery and chemotherapy decline rapidly with age. The findings of recent studies have disputed the previously held belief that older patients do worse after bowel surgery or chemotherapy. Evidence supports the safety and efficacy of both adjuvant and palliative chemotherapy in fit old patients. Elderly CRC patients with age-related comorbidity can still benefit from optimal strategies.Therefore,we still have a lot of work to do to improve the overall survival and time to tumor recurrence of elderly CRC patients. Laparoscopic colonic resection is a safe and effective surgical technique in elderly patients. We look forward to the development of Natural Orifice Transluminal Endoscopic Surgery （NOTES）,which will benefit the elderly CRC patients in future.