The treatment paradigm in older patients with malignant hemopathies is the choice between an effective conservative treatment that preserves quality of life and an intensive, potentially curative treatment with more toxicities. For each patient, it is important to determine the risk/benefit ratio. The patient should be involved in the discussion, sufficiently informed and able to express himself and his expectations in terms of quality of life. However, this informed consent is conditioned by the ability of the patient to understand the risks and benefits of the treatment. Decline in quality of life is an important parameter for older patients with cancer and many prospective trials have now confirmed the impact of different side effects of treatment, such as recurrent hospitalization, loss of autonomy in daily activities, loss of contact with grandchildren and loss of cognitive functions. Interventions oriented to vulnerabilities detected in the older patients (by comprehensive geriatric assessment) and an optimal approach, including preventive measures to reduce treatment-related toxicity and mortality, are directly correlated to improvement in quality of life.
老年恶性血液病患者的治疗模式，是在保留生活质量的保守有效治疗与更具毒性但可能根治的强化治疗之间做出选择。对每位患者而言，评估风险获益比至关重要。患者应参与治疗决策讨论，在充分知情且能自主表达诉求及生活质量期望的前提下进行选择。然而，这种知情同意取决于患者理解治疗风险与获益的能力。生活质量下降是老年癌症患者的重要评估指标，多项前瞻性研究已证实治疗相关副作用的多维影响，包括反复住院、日常生活能力丧失、与孙辈互动减少以及认知功能下降。通过老年综合评估识别患者脆弱性，并采取针对性干预措施及优化治疗方案（包括预防性降低治疗相关毒性和死亡率的策略），与生活质量的改善直接相关。
Supportive Care in Older Lymphoma Patients to Reduce Toxicity and Preserve Quality of Life
肿瘤(癌症)患者之家