[Treatment of malignant non-Hodgkin's lymphomas in elderly patients]

The number of elderly patients with non-Hodgkin's lymphomas (NHL) is continuously increasing. The diagnostic and staging procedures should be carried out in elderly patients as careful as in younger patients. Furthermore, for treatment decisions geriatric assessment and the patient's preferences concerning therapy are essential and have to be considered. The treatment of indolent NHL depends on the stage of the disease and the clinical status of the patient. Most of the patients with limited indolent NHL can be treated with curative intent using localized irradiation. Treatment of patients with advanced indolent NHL is palliative. In contrast, all stages of aggressive NHL can also be treated with curative intent in elderly patients. In limited aggressive NHL standard treatment consists of polychemotherapy followed by involved field irradiation. Standard treatment of advanced aggressive NHL is polychemotherapy with cyclophosphamide, adriamycin, vincristine and prednisone (CHOP). The goal for the near future is to improve perspectives for elderly patients with NHL. One way is to treat as many of these patients as possible according to current standards. In the field of geriatric oncology, one of the questions we are often confronted with is the limitation of treatment, especially in frail patients. This issue is closely associated with ethical considerations which are discussed in another paper.