老年肿瘤评估及决策新体系

A new system for tumor evaluation and decision-making in elderly patients with cancer

中国已进入老龄化社会,而恶性肿瘤即是衰老疾病的一种。恶性肿瘤在老年人群中发病率普遍偏高,衰老和肿瘤存在一定的内在联系。老年肿瘤患者具有其独特性,如伴随疾病、多重用药、虚弱状态、认知障碍等,限制了常规抗肿瘤治疗模式在老年这一特殊人群中的应用。故而,老年肿瘤患者的治疗决策很大程度上依赖于完善的动态老年评估,完善的评估可预测老年肿瘤患者是否可从常规抗肿瘤治疗模式中获益。此外,因伦理要求,多数临床研究设置了入组年龄上限,基于此所获之临床证据难以指导高龄肿瘤患者的临床实践,故亟需在该领域有所创新。本文就上述领域的研究现状及发展趋势进行综述,并针对老年肿瘤人群的全面评估和精准临床决策进行讨论。

China’s population is aging,and cancer is an aging-related disease.The incidence of malignant tumors is generally high in the elderly.There is a fundamental link between aging and cancer.In addition,elderly patients with cancer have unique characteristics,such as comorbidities,polypharmacy,frailty,and cognitive impairment,which limit the application of conventional anti-tumor therapies in this special population.Therefore,treatment decision-making for elderly cancer patients is largely dependent on excellent dynamic geriatric assessment,which can predict whether these patients will benefit from conventional anti-tumor therapies.Furthermore,due to ethical requirements,most clinical studies set an upper age limit for enrollment.Based on this clinical evidence,clinical management of elderly patients with cancer is difficult,and innovations in this field are urgently needed.This article reviews the current research and development trends in the aforementioned area and discusses the comprehensive evaluation and accurate clinical decision-making for elderly patients with cancer.