Yaşlı Küçük Hücreli Dışı Akciğer Kanserli Hastaya Yaklaşım

Küçük hücreli dışı akciğer kanseri (KHDAK), akciğer kanserlerinin %80'ini oluşturur ve tüm dünyada kansere bağlı ölümlerin başında gelir. Yaşam süresi uzadıkça, yaşlılarda akciğer kanseri görülme insidansı artmaktadır. Yaşlı hastalarda sık görülen komorbid durumlar ve organ fonksiyonlarındaki fizyolojik ilerleyici kayıplar uygun tedavi seçimlerini güçleştirmektedir. Bazı hastalar kemoterapiyi gençler kadar iyi tolere edebilirken, bazıları ciddi toksisiteler yaşamakta ve tedavi modifikasyonlarına gerek duyulmaktadır. Burada önemli olan standart veya hafifletilmiş tedavinin uygulanacağı hastaları etkin bir biçimde seçmektir. Başlangıçta yapılacak kapsamlı geriatrik değerlendirme yaşlı hastada seçilecek en uygun tedavi rejimini belirlemede yararlı bir araçtır. Günümüze kadar yapılan çok az sayıda çalışmada yaşlı KHDAK'li hastalar üzerinde yoğunlaşılmıştır, bunlarda özellikle ileri evre hastaları içermektedir. Erken evrelerdeki tedaviye yönelik yaşlılara özgü prospektif çalışma yoktur. Bu makalede özellikle yaşlı KHDAK'li hastalarda kapsamlı geriatrik değerlendirme üzerinde durulacak ve yaşlı KHDAK'li hastalarda tüm evrelerdeki güncel tedaviler gözden geçirilecektir

Management of Non-Small Cell Lung Cancer in the Elderly

Non-small cell lung cancer (NSCLC) remains the leading cause of cancer-related mortality worldwide, representing 80% of lung cancer cases. As a result of increasing life expectancy, the incidence of lung cancer diagnosed in the elderly is rising. Elderly patients often have comorbid conditions and a progressive physiological reduction in organ function, which make the selection of proper treatment difficult. While some patients are able to tolerate chemotherapy as well as their younger counterparts, others experience severe toxicity and require treatment modifications. Thus, a major issue is effectively selecting patients suitable for standard or attenuated therapy. A comprehensive geriatric assessment performed at baseline is a useful tool that can help the best treatment regimen to be administered in the elderly. Until now, there have been only a few trials specifically focused on elderly NSCLC patients, particularly those with advanced disease. Prospective elderly-specific studies in early stages are still lacking. This paper particularly focuses on comprehensive geriatric assessment in elderly NSCLC patients and reviews the most recent therapies for the treatment of all stages of NSCLC in the elderly

Kaynakça

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Kaynak Göster

Solunum
  • ISSN: 1302-4922
  • Yayın Aralığı: Yılda 0 Sayı
  • Başlangıç: 2018

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