高风险疾病的老年患者的系统治疗
1Department of Medical Oncology, Institut Curie, Saint-Cloud, France.
概括
老年乳腺癌患者的辅助治疗需要调整,因为脆弱性和副作用的风险. 老年人的评估和患者的偏好对于个性化,有效的护理,改善生活质量至关重要.
科学领域:
- 老年瘤学 老年瘤学
- 乳腺癌的治疗方法
- 临床决策 - 临床决策
背景情况:
- 老年乳腺癌患者的辅助全身治疗通常需要与年轻人相比改变剂量或时间表.
- 在70岁以上的患者中常见的脆弱性增加了化疗,内分泌疗法和向治疗不良事件的风险.
- 在老年人中,由于与年龄相关的功能储备下降,药理动力学可能会产生误导作用.
研究的目的:
- 突出对老年乳腺癌患者辅助系统治疗的挑战和必要的调整.
- 强调老年评估和以患者为中心的护理在优化治疗决策中的重要性.
- 倡导将分子测试与老年因素整合为全面的辅助治疗规划.
主要方法:
- 对老年乳腺癌患者的辅助疗法的挑战进行审查,包括脆弱性,副作用和药理动力学变化.
- 分析老年医疗评估对治疗决策的影响,并指出显著的变化和降级率.
- 考虑患者的期望,生活质量,以及多病症在治疗结果中的作用.
主要成果:
- 在多学科团队中整合的老年人评估导致治疗决策发生30-50%的变化,在三分之二的病例中缓解治疗.
- 老年患者优先考虑功能,认知健康和独立,这往往与标准的剂量强度模型相冲突.
- 对高风险瘤的分子检测应与老年因素相结合,以便更好地选择辅助治疗.
结论:
- 老年乳腺癌患者的辅助治疗决策必须考虑到脆弱性,并发症和个体患者的目标,优先考虑生活质量.
- 从无关年龄的协议转向个性化的方法,包括老年评估和患者偏好,这是必不可少的.
- 将先进的分子诊断与全面的老年病学评估相结合,为优化老年乳腺癌幸存者的辅助治疗提供了更全面的战略.
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