73例70岁以上妇女妇科恶性肿瘤手术分析

[目的]探讨70岁以上妇科恶性肿瘤患者手术的耐受情况。[方法]收集浙江省肿瘤医院自1996年1月到2001年12月间,70岁以上妇科恶性肿瘤患者接受盆腔姑息性和根治性手术治疗73例,分析不同年龄及手术范围对术后恢复的影响。[结果]73例患者66例选择了根治性手术,7例接受姑息性手术。术后70~75岁组和>75岁组,其手术方式、平均住院时间、术前术后并发症等无明显差别。术中出血量、手术时间及并发症发生率均明显较姑息性手术组增加,12例严重并发症中,11例发生在根治性手术组。[结论]经过严密的术前准备、术后处理,70岁以上的老年妇女能够耐受根治性手术治疗。     

老年肿瘤病人麻醉处理300例分析

AnAnalysisofAnesthesiaof300ElderCaseswithCarcinomaXuHaifeng;LiuWei(AnesthesiaDept.ofBeijingSino-JapaneseFriendshipHospital,Beijing100029)随着我国人口平均寿命的延长．老年肿瘤的发病率随之上升，需要手术治疗的老年患者相应增加。本文报告我院1984年10月～1994年8月300例7O岁以上老年肿瘤患者的麻醉处理体会，总结如下。1临床资料300例中男性217例，女性83例；其中：70岁～75岁211例；76岁～80岁68例；81岁～85岁19例；86岁以112例；最高年龄87岁。手术部位：恶性肿瘤283笼；良性肿瘤17例。其中头颈部17例；胸部48例；…     

408例70岁以上老年肺癌患者的预后因素分析

背景与目的 随着人口老龄化,老年肺癌的发病率呈上升趋势.统计数据显示在过去的10年中,70岁以上人群中肺癌发生率及死亡率较前增加.本文以70岁作为老年肺癌的分界线,旨在分析影响其预后的因素.方法 回顾性分析408例70岁以上老年肺癌患者资料,利用SPSS 13.0统计软件进行单因素及COX回归多因素分析,探讨性别、年龄...     

恶性肿瘤的放射治疗与带状疱疹

1978年至1986年,我院共放射治疗各种恶性肿瘤患者1179例,其中10例发生带状疱疹,现就其临床特点分析如下。 临床资料 1179例接受放疗的恶性肿瘤患者中,发生带状疱疹者男7例,女3例。年龄分布为20～70岁。 本组带状疱疹的发病率占总数的0.85％,其中     

高龄胃癌患者临床治疗分析

胃癌是我国最常见的恶性肿瘤,随着老龄人口的增多,老年胃癌患者受到了更多重视。我科自1993～1998年共收治老年胃癌患者(年龄>70岁)85例,现分析报告如下。 一、临床资料 1.一般资料:本组男58例,女27例。年龄70～85岁,平均78.4岁。     

65岁以上中国老年女性原发性乳腺癌临床病理特征及治疗分析：多中心10年回顾性研究

[目的]研究65岁以上老年女性原发性乳腺癌的风险暴露因素、临床病理特征以及治疗特征,为老年女性乳腺癌的诊治提供依据.[方法]回顾性分析全国7个不同地区具有代表性的7家医院收集的4211例乳腺癌患者信息,将65岁以上患者作为研究对象(老年组),50～64岁年龄组作为对照组.统计学方法为卡方检验和Fisher精确检验,P＜0.05具有统计学意义.[结果]65岁以上老年乳腺癌患者占同期乳腺癌患者的8.33％(351/4211).平均诊断年龄和平均绝经年龄分别为70.2岁(65～86岁)和49.59岁(32～58岁).与对照组相比,老年组具有以下特征:以体力工作、生育大于一胎、低学历、结婚早和初次生育年龄早者显著;临床病理特征方面,老年患者区域淋巴结转移少、分期早(即更多的0+Ⅰ+Ⅱ期患者)、激素受体阳性率高、Hey2低表达、Her-2亚型和三阴性亚型少.在侵袭性治疗方面,老年患者较少接受改良根治术、保乳术、放疗、化疗,更多的是接受乳腺单纯切除术.两组间内分泌治疗无显著差异.[结论]老年乳腺癌患者有较好的临床病理特征和生物学行为;接受侵袭性治疗少;内分泌治疗需要加强.     

内分泌治疗在老年女性乳腺癌治疗中的临床价值

目的:探讨内分泌治疗在老年女性乳腺癌治疗中的价值.方法:回顾性分析704例70岁及以上老年女性乳腺癌患者的临床病理资料和系统的随访资料.结果:704例患者平均年龄77.8岁,其中70岁～79岁占88.9%.TNM分期Ⅰ期和Ⅱ期占76.1%;病理类型以浸润性导管癌和小管癌为主,占85.2%;腋下淋巴结转移率41.6%.手术以乳腺癌改良根治术和单纯切除术为主,占59.1%;术后局部并发症发生率为12.2%,主要为胸壁皮下或腋窝积液和切口部分皮瓣坏死.术后内分泌治疗占66.6%.术后2年、5年和10年生存率分别为92.8%、75.3%和69.5%.结论:内分泌治疗可以作为老年乳腺癌患者手术后的首选治疗方案,但尚需积累更多有关老年乳腺癌治疗的临床经验.     

70岁以上老年女性乳腺癌患者的特点和预后分析

目的 分析70岁以上老年女性乳腺癌患者的临床及病理特点、生存率和影响预后的因素。方法收集1980年1月至2003年12月收治的280例70岁以上老年乳腺癌患者的临床资料,观察患者长期生存率,分析其临床特点及影响预后的因素。结果全组280例老年乳腺癌占同期收治乳腺癌患者的2．9％。92．5％的患者以乳房肿块为首发症状,中位就诊时间为4个月,58．9％的患者合并有其他疾病。主要病理类型为浸润性导管癌（74．3％）。免疫组化分析显示,雌、孕激素受体阳性者占72．9％。全组患者5、10年总生存率分别为69．9％和40．6％。单因素分析显示,肿瘤大小、淋巴结状态、分期、脉管瘤栓和内分泌治疗是影响预后的因素;多因素分析显示,淋巴结状态和脉管瘤栓是影响预后的独立因素。结论老年乳腺癌具有独特的临床和病理特点,手术和内分泌治疗是主要和有效的治疗方式。影响预后的独立因素是淋巴结状态和脉管瘤栓。     

老年恶性肿瘤 70 例临床分析

目的总结老年恶性肿瘤特点,分析老年恶性肿瘤患者延误诊断相关因素,探讨制订相应诊断对策。方法对70例60岁以上住院治疗的老年恶性肿瘤患者的临床特征进行回顾性分析。结果70例患者的患病部位涉及呼吸、消化、泌尿、神经等多个系统和器官,其中肺癌患病率最高（34．3％）;患者就诊时间晚,发病至确诊时间平均6．2个月（2天至12个月）,临床表现不典型,病理诊断率低（51．4％）;确诊时临床分期多为晚期,Ⅲ～Ⅳ期患者的比例为78．6％;所有患者中前列腺癌肿瘤标志物阳性率最高（100．0％）;院内死亡原因多为感染（69．0％）。结论加强埘老年人的肿瘤筛查,警惕老年患者的不典型症状,合理选用辅助检查,提高早期诊断比例。旦确诊,应进行老年综合评估（comprehensive geriatric assessmeHt,CGA）,制订个体化治疗方案,提高患者生存质量。     

70岁以上老年肺癌患者对化疗耐受情况的临床观察

肺癌患者中70岁以上占30％，大多数就诊时已属晚期。老年患者的化疗一直有争议，担心不能耐受化疗，束缚了临床医师对老年肺癌患者的治疗。目前将老年人多定义为70岁以上。自1998年4月至2005年2月我们治疗37例自愿接受化疗的老年晚期肺癌患者，现报告如下。     

280例乳腺癌患者贫血情况临床分析

目的：研究乳腺癌患者初诊时和治疗前后的血红蛋白（Hb）变化、贫血发生情况及其与临床分期、年龄和治疗等方面的关系。方法：对我院近10年期间住院的280例乳腺癌患者进行回顾分析，研究治疗前后Hb值的变化和贫血的发生例数，并按临床分期和年龄分组进行分析。结果：（1）280例患者初诊时贫血发生率25．0％，治疗前后总发生率42．9％。Ⅰ级74例（61．6％），Ⅱ级38例（31．7％），Ⅲ级6例（5．0％），Ⅳ级2例（1．7％）。（2）CMF方案化疗贫血发生率30．4％（17／56），而CAF方案为26．8％（14／41）。（3）Ⅱ期、Ⅲ期和Ⅳ期患者治疗后的Hb值明显低于治疗前（P〈0．05）；随着分期的提高，贫血发生率增高，但无统计学意义（P〉0．05）。（4）贫血发生与年龄密切相关（P〈0．01），老年患者贫血发生率61．5％，明显高于非老年患者的37．2％（P〈0．01）。（5）贫血程度NCI分级则与临床分期、年龄无明显相关。结论：乳腺癌患者有较高的贫血发生率，贫血的发生与临床分期和治疗有一定相关性，尤其与患者年龄密切相关，老年患者更易发生贫血。     

Treatment of non-small-cell lung cancer in older persons

The majority of individuals diagnosed with lung cancer in the United States are 70 years of age and older. Defining appropriate therapy for older patients with non-small-cell lung cancer (NSCLC) is becoming a major focus of clinical research. In this article, we review the available data on clinical predictors of risk and benefit for elderly NSCLC patients receiving treatment via a variety of modalities, including surgery, radiotherapy, combined radiotherapy and chemotherapy, and chemotherapy alone. The data demonstrate that subgroups of elderly patients benefit from appropriately selected treatment. Participation of older patients in clinical trials designed to assess efficacy, toxicity, and quality-of-life outcomes for recently developed treatment modalities in this population is critical.     

Management of Elderly Patients with Advanced Non-Small Cell Lung Cancer in Turkey

Objective: Non-small cell lung cancer is a disease that affects the elderly. However, most patients older than70 years are less likely to receive standard therapy than their younger counterparts and the aim of the presentstudy was to determine age-dependent variation in efficacy. Subjects and Methods: Between 2004-2008, 40consecutive patients older than 70 years received treatment for advanced non-small cell lung cancer. All wereevaluated for response and toxicity. Chemotherapy was either with cisplatin or carboplatin and double or singleagents (vinorelbine, gemcitabine). Docetaxel was used as a second line therapy in selected cases. Patients weregrouped according to age: group 1 (70-74 years), group 2 (≥ 75 years). Results: Except for 4 cases, all receivedchemotherapy, and 61 % were given a cisplatin-containing regimen. Second-line therapy was given to 42.5%and grades 3-4 neutropenia was seen in 17 (42.5%). Only one patient died due to neutropenic fever. Nephrotoxicitywas observed in 2 (5%) and one underwent hemodialysis. Overall survival was 10 months, with median survivalperiods for groups 1 and 2 of 13 and 10 months, respectively (p>.05). No differences were found regarding typeof chemotherapy administered or adverse events between the 2 groups. Conclusion: Patients older than 75years appear to deserve the same standard therapy for non-small cell lung cancer as that given to younger cases.     

Management issues for elderly patients with breast cancer

Opinion statement Fifty percent of breast cancers occur after the age of 65 years and 25% occur after the age of 75 years. Encountering a breast cancer in an older woman is frequent. After years of dearth of data specific to the elderly, some evidence is beginning to accumulate concerning breast cancer in the older woman. Recent data from mammography studies confirm its effectives in women with 10 years or more of life expectancy (perhaps even 5 years). Epidemiologic and randomized studies demonstrate that a proper surgery and adjuvant treatment can decrease relapse and improve survival in patients older than 80 years. Radiation therapy studies show a decrease in local relapse even in patients older than 70 years. Adjuvant hormonal therapy has essentially the same effectiveness as in younger women. Chemotherapy has a role in patients older than 70 years. Consensus statements, such as the St. Gallen consensus, have dropped the age limit of 70 years from their recommendations. Comorbidity and life expectancy should be taken into account for proper selection of adjuvant treatment. The treatment of metastatic breast cancer has evolved significantly with the introduction of aromatase inhibitors, new chemotherapeutic agents, and targeted biologic agents. New chemotherapeutic agents are as effective as single agents compared to older and more toxic drug combinations. The cumulative result of the introduction of these new agents, at a population level, is a 7.5-month increase in the median survival time of patients with metastatic breast cancer over the past decade.     

Efficacy of first-line letrozole versus tamoxifen as a function of age in postmenopausal women with advanced breast cancer

PURPOSE: To compare the efficacy, in regard to time to progression (TTP) and objective response rate (ORR), of letrozole (Femara; Novartis Pharma AG; Basel Switzerland), an oral aromatase inhibitor, with that of tamoxifen (Tamofen; Leiras OY; Turku, Finland) as first-line therapy in younger (<70 years) and older (>/=70 years) postmenopausal women with advanced breast cancer. MATERIALS AND METHODS: Nine hundred seven patients with advanced breast cancer were randomly assigned to receive 2.5 mg letrozole (n = 453) or 20 mg tamoxifen (n = 454) once daily in a double-blind, multicenter, international trial. Among the prospectively planned analyses were analyses of TTP and ORR by age (<70 and >/=70 years). The results of these prospectively planned analyses are reported here. RESULTS: Letrozole was as effective in older postmenopausal women (>/=70 years of age) as it was in younger postmenopausal women (<70 years of age). The overall ORR in the older subgroup was significantly higher in patients treated with letrozole (38%) than in patients treated with tamoxifen (18%). In the younger subgroup of postmenopausal patients, the ORRs were not significantly different (letrozole, 26%; tamoxifen, 22%). TTP was significantly longer for letrozole than for tamoxifen in both age groups (younger: letrozole median TTP, 8.8 months; tamoxifen, 6.0 months; older: letrozole median TTP, 12.2 months; tamoxifen, 5.8 months). Although age was independently prognostic of TTP, there was no significant effect of age on ORR in the presence of other factors. CONCLUSION: The data show that letrozole, 2.5 mg once daily, is as effective in older, postmenopausal women as it is in younger postmenopausal women with advanced breast cancer. In addition, letrozole was more effective than tamoxifen in both younger and older patients.     

3D conformal radiation therapy for prostate cancer in elderly patients.

BACKGROUND AND PURPOSE: The aim of this study was to evaluate if conformal radiation therapy for localized prostate cancer with doses of 70 Gy is well tolerated in patients aged 75 years or older, and if the side effects and the biochemical recurrence free (bNED) survival are comparable to younger patients. PATIENTS AND METHODS: Eighty patients>or=75 years received definitive conformal radiotherapy for prostate cancer. Acute and late side effects as well as bNED survival (ASTRO criteria) were compared to 221 patients younger than 75 years who were treated during the same period of time. RESULTS: Median dose to the prostate was 70 Gy in both groups. There were no significant differences in acute or late side effects between age groups. The frequency of grade III late symptoms was low and ranged between 0 and 4% for the evaluated symptoms irrespective of age group. Older patients had a better bNED survival than younger patients (bNED survival at 4 years: 76 vs. 61%, P=0.042). CONCLUSIONS: High-dose conformal radiation therapy for prostate cancer is well tolerated in patients aged 75 years or older. In terms of bNED survival radiation treatment is at least as effective as it is for younger patients.     

电视胸腔镜手术治疗老年肺癌151例临床分析

目的 探讨胸腔镜手术治疗老年肺癌患者的可行性及应用价值.方法 回顾分析151例70岁以上老年肺癌施行胸腔镜肺癌根治手术的临床资料.结果 全组无手术死亡,并发症发生率18.5%(28/151).其中心律失常12例,肺部感染9例,肺不张3例,切口感染2例.结论 对于老年肺癌患者在严格掌握手术适应证及充分围手术期处理的前提下,采用胸腔镜手术行肺叶切除及淋巴结清扫,是安全可行的,可以降低并发症发生率,提高老年肺癌的治疗效果.     

电视胸腔镜手术治疗老年肺癌151例临床分析

目的：探讨胸腔镜手术治疗老年肺癌患者的可行性及应用价值。方法：回顾分析151例70岁以上老年肺癌施行胸腔镜肺癌根治手术的临床资料。结果：全组无手术死亡,并发症发生率18.5%（28/151）。其中心律失常12例,肺部感染9例,肺不张3例,切口感染2例。结论：对于老年肺癌患者在严格掌握手术适应证及充分围手术期处理的前提下,采用胸腔镜手术行肺叶切除及淋巴结清扫,是安全可行的,可以降低并发症发生率,提高老年肺癌的治疗效果。     

高龄肺鳞癌患者的临床病理特征

背景与目的随着人口老龄化及烟草的流行,老年肺癌患者的发病率呈上升趋势。但在各种临床实验中老年（≥70岁）患者不入组或很少入组,使得老年肺鳞癌患者的临床研究证据不足。本研究以80岁患者为界,观察分析高龄肺鳞癌患者的临床特征、治疗方法及影响治疗的因素并探讨高龄肺鳞癌患者治疗的选择。方法回顾性分析38例老年高龄肺鳞癌患者的临床特征,总结高龄肺鳞癌患者在诊断及临床分期明确的情况下选择治疗方式。结果老年高龄鳞癌患者在身体状况可以耐受的情况下,可以根据患者的诊断及临床分期选择手术、放疗及化疗。结论老年高龄患者由于其生存期较短,能够接受的有效及完整的治疗较老年（70岁-80岁）患者要少,≥80岁的肺鳞癌患者在其身体状况允许及不影响生活质量的情况下,根据其病情分期应选择最佳的治疗。