adjuvant chemotherapy in the elderly- whom to treat, what regimen-.docVIP

Adjuvant Chemotherapy in the Elderly: Whom to Treat, What Regimen? nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp; 作者：Susan Burdette-Radoux, Hyman B. Mussnbsp;nbsp; 【关键词】nbsp; Aged,amp;#8226;,Chemotherapy,amp;#8226;,adjuvant,amp;#8226;,Neoplasms,amp;#8226;,Risk,assessment 　　LEARNING OBJECTIVESnbsp; 　　After completing this course, the reader will be able to: 　　Describe several methods for assessing a patient’s comorbidity and functional status prior to adjuvant chemotherapy. 　　Discuss methods of relapse and mortality risk assessment in the elderly population and explain how adjuvant treatment affects risk. 　　Identify adjuvant chemotherapy regimens that have been shown to be beneficial in the elderly population for treating breast, colon, and lung cancer. 　　ABSTRACTnbsp; nbsp; 　　As the elderly population continues to grow, adjuvant chemotherapy treatment in the elderly is becoming an increasingly important issue for the practicing oncologist. Decisions regarding adjuvant treatment involve a careful assessment of the risk for recurrent disease and side effects from treatment, balancing these risks against the beneficial effects of treatment. In this review, we discuss methods for assessing the elderly patient in terms of life expectancy, comorbid disease, and functional capacity. This assessment can then be used to help identify appropriate candidates for adjuvant chemotherapy. Tools for estimating the risk for relapse and mortality and the reduction in these risks with various forms of treatment are useful for clarifying treatment options. Elderly patients have been underrepresented in clinical trials, and patients are often given less intense and possibly inferior standard treatment as a function of age. Ongoing clinical trials targeting the elderly patient may help answer questions about the relative risks and benefits of adjuvant treatment in this age group. Recent data show that most fit elderly patients derive a benefi