진행성 노인 위암에 대한 항암요법
Chemotherapy for Advanced Gastric Cancer in Elderly Patients
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Cancer, including gastric cancer, occurs predominantly in older patients. Although there is no single internationally acceptedstandard chemotherapy regimen for unresectable or metastatic gastric cancer (MGC), doublet combination chemotherapy using fluoropyrimidineand platinum is regarded as the reference treatment. However, most of the clinical trials that were based on the currenttreatment guidelines were performed in patients < 70 years of age with good performance status (PS). Therefore, the clinicalapplication of these guidelines to elderly individuals is limited. The available data suggest that older patients with good PS are ableto tolerate the same chemotherapy regimens as younger patients with MGC, and that they achieve a similar efficacy. In contrast,some studies showed that the same efficacy was achieved at the expense of increased toxicity in older patients, emphasizing the importanceof patient selection. Many studies have actively investigated elderly patients with MGC, including randomized phase 3studies comparing fluoropyrimidine and platinum doublets with fluoropyrimidine alone. Although an advanced age alone shouldnot preclude the use of effective chemotherapy in MGC, more data regarding age-specific clinical trials are needed to guide optimaltreatment in elderly patients.
Abstract
Cancer, including gastric cancer, occurs predominantly in older patients. Although there is no single internationally acceptedstandard chemotherapy regimen for unresectable or metastatic gastric cancer (MGC), doublet combination chemotherapy using fluoropyrimidineand platinum is regarded as the reference treatment. However, most of the clinical trials that were based on the currenttreatment guidelines were performed in patients < 70 years of age with good performance status (PS). Therefore, the clinicalapplication of these guidelines to elderly individuals is limited. The available data suggest that older patients with good PS are ableto tolerate the same chemotherapy regimens as younger patients with MGC, and that they achieve a similar efficacy. In contrast,some studies showed that the same efficacy was achieved at the expense of increased toxicity in older patients, emphasizing the importanceof patient selection. Many studies have actively investigated elderly patients with MGC, including randomized phase 3studies comparing fluoropyrimidine and platinum doublets with fluoropyrimidine alone. Although an advanced age alone shouldnot preclude the use of effective chemotherapy in MGC, more data regarding age-specific clinical trials are needed to guide optimaltreatment in elderly patients.
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