KCTBASE

노인에서의 폐암치료
Treatment of lung cancer in the elderly

대한내과학회지 2008년 75권 2호 p.162 ~ p.168

이정은(Lee Jeong-Eun) - 충남대학교병원 내과
김선영(Kim Sun-Young) - 충남대학교병원 내과

Abstract

폐암은 노령인구에서 가장 문제가 되는 암으로 절반 가까운 환자가 65세 이상의 나이를 나타내므로 폐암으로 진단받은 노인 환자는 점차 늘어날 수 밖에 없다. 따라서 단순히 노령이라는 이유 때문에 치료를 포기할 수가 없다. 장기의 기능과 동반질환을 고려하여 적절한 약제와 용량, 그리고 치료방법을 선택한다면 부작용을 최소화하면서도 그 효과가 잘 나타나게 하는 것이 관건이다. 절대적인 나이는 생존에 대한 예측인자가 되지 못하며 충분히 개개인의 평가만 이루어진다면 70세 또는 75세까지는 대부분 현재의 표준치료를 시행하는 것이 적절하다고 보며 또한 앞으로 개개인에 대한 적절한 맞춤 치료를 기대해 보는 상황에서는 더욱 그렇다.

Elderly patients frequently experience progressive decline of organ function and multiple comorbidities, which need to be considered when choosing therapy. In early non-small cell lung cancer (NSCLC), surgical resection is the mainstay of
curative treatment with a favorable survival even in the elderly. But postoperative mortality following pneumonectomy is
high, and this operation should only be performed in selected patients with acceptable heart-lung function. In locally
advanced NSCLC, combined chemoradiotherapy is effective in younger patients and in older patients, despite increased
toxicity. Platinum based combination chemotherapy is similar in fit older and younger patients with increased but
acceptable toxicity for elderly patients. Single agent chemotherapy with a third generation agent (gemcitabine, vinorelbine,
taxanes) could be considered a reasonable treatment option for elderly patients. Target therapy with pemetrexed, gefitinib
and erlotinib is feasible to treat elderly patients. In limited disease small cell lung cancer (SCLC), concurrent
chemoradiotherapy seem to be superior to sequential approach and yield higher survival despite increased toxicity. In case of elderly patients, it is not supported by prospective trials. Prophylactic cranial irradiation is the standard treatment in
limited disease SCLC except patients with cognitive dysfunction. In extensive disease SCLC, platinum based
chemotherapy is standard treatment. Many studies demonstrate that the elderly patient with a good performance status
(PS) can tolerate chemotherapy that has similar toxicity and benefits as nonelderly patients. But, the assessment of
comorbidity and the evaluation of functional status are prerequisite for benefit in elderly patients. It can be useful, not only for providing important information to the patients, but also for the correct choice of treatment. (Korean J Med 75:162-168, 2008)

키워드

노인, 폐암, 치료

Elderly, Lung cancer, Treatment

KMID : 0882420080750020162

원문 및 링크아웃 정보

학회

등재저널 정보

주제코드

주제명(Target field)

연구대상(Population)

연구참여(Sample size)

대상성별(Gender)

질병특성(Condition Category)

연구환경(Setting)

연구설계(Study Design)

연구기간(Period)

중재방법(Intervention Type)

중재명칭(Intervention Name)

키워드(Keyword)

유효성결과(Recomendation)

Single agent chemotherapy with a third generation agent (gemcitabine, vinorelbine,

연구비지원(Fund Source)

근거수준평가(Evidence Hierarchy)

출판년도(Year)

참여저자수(Authors)

대표저자

DOI

KCD코드

ICD 03

건강보험코드

노인에서의 폐암치료 Treatment of lung cancer in the elderly

Abstract

키워드

노인에서의 폐암치료
Treatment of lung cancer in the elderly