Colorectal cancer (CRC) is a common tumor, and its incidence increases with age. Elderly CRC patients constitute a daily challenge for oncologists when deciding if they are worthy of active treatments and of which kind, as data from the literature are incomplete or even lacking in specific subsets. To fill this gap, we conducted a narrative review that included not only studies dedicated to the elderly but also extracted elderly groups from major clinical trials. Results in terms of harm and benefit were dissected according to frailty categories (fit, vulnerable, unfit). As it emerged, the management of elderly CRC patients should be based not on age alone, but rather on their frailty level, as assessed by Comprehensive Geriatric Assessment (CGA), which should be implemented in trials and clinical practice. Elderly patients should be treated similarly to young patients in the first and subsequent lines, without precluding the use of innovative drugs. Vulnerable elderly individuals should receive personalized schedules that focus more on symptoms and quality of life; for frail patients, supportive care alone is often a valid option.
结直肠癌是一种常见肿瘤，其发病率随年龄增长而升高。由于现有文献数据在特定亚组中存在不完整甚至缺失的情况，老年结直肠癌患者是否值得接受积极治疗以及选择何种治疗方案，成为肿瘤科医生日常面临的挑战。为填补这一空白，我们进行了叙述性综述，不仅纳入针对老年群体的研究，还从主要临床试验中提取老年亚组数据，并依据衰弱程度分类（健康、脆弱、衰弱）对治疗获益与风险进行剖析。研究表明，老年结直肠癌患者的治疗决策不应仅基于年龄，而应依据综合老年评估确定的衰弱程度制定，该评估体系应在临床试验和临床实践中推广应用。在初始治疗及后续治疗中，健康老年患者应与年轻患者采用相似的治疗方案，且不应排除创新药物的使用；脆弱老年患者应接受更注重症状控制和生活质量的个体化方案；而对于衰弱患者，单纯支持治疗通常是合理选择。
肿瘤(癌症)患者之家