การรักษามะเร็งที่พบบ่อยในผู้ป่วยสูงอายุ
การรักษาโรคมะเร็งที่พบบ่อยในผู้ป่วยสูงอายุ
คำสำคัญ:
มะเร็งในผู้ป่วยสูงอายุ, การรักษามะเร็ง, เครื่องมือคัดกรองมะเร็งในผู้ป่วยสูงอายุบทคัดย่อ
โรคมะเร็งเกิดจากความผิดปกติของเซลล์ในอวัยวะต่างๆ ของร่างกายซึ่งเจริญเติบโตเป็นก้อนเนื้อที่สามารถแพร่กระจายไปยังอวัยวะข้างเคียงได้ เป็นสาเหตุการตายอันดับสองรองจากโรคหัวใจ โรคมะเร็งได้คร่าชีวิตคนทั่วโลก ไปกว่า 9.6 ล้านคนในปี พ.ศ. 2561 พบมากในกลุ่มผู้สูงอายุ ดังนั้นการรักษามะเร็งในผู้สูงอายุจึงเป็นสิ่งที่สำคัญ ซึ่งแตกต่างจากกลุ่มอายุน้อยโดยเฉพาะผลข้าง เคียงของการรักษา จึงควรใช้เครื่องมือคัดกรองในผู้สูงอายุและประเมินภาวะสุขภาพของผู้สูงอายุอย่างครอบคลุม จากรายงาน ทะเบียนโรคมะเร็งโรงพยาบาลพระปกเกล้า จังหวัดจันทบุรี ระหว่าง พ.ศ. 2558 ถึง พ.ศ. 2562 พบว่ามะเร็ง 3 อันดับแรกในผู้สูงอายุ (อายุมากกว่า 60 ปี) เพศชาย ได้แก่ มะเร็งปอด มะเร็งตับ และมะเร็งลำไส้ใหญ่ตามลำดับ ส่วนในผู้สูงอายุเพศหญิง ได้แก่ มะเร็งเต้า นม มะเร็งลำไส้ใหญ่และมะเร็งปอดตามลำดับ บทความนี้ได้นำเสนอตัวอย่างเครื่องมือคัดกรองในผู้สูงอายุรวมถึงการรักษามะเร็งที่พบบ่อยในผู้สูงอายุ ได้แก่ มะเร็งปอด มะเร็งลำไส้ใหญ่ มะเร็งเต้านม และมะเร็งตับ
References
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2. Foundation of Thai Gerontology Research and Development Institute. Situation of the Thai elderly 2018. Bangkok, Thailand:Amarin Printing and Publishing; 2018.
3. Ministry of Public Health, National Cancer Institute. National Cancer Institute Strategic Plan 2019-2022 [Internet]. 2018 [cited 31 July 2020]. Available from: http://www.nci.go.th/th/Today/download/แผนยุทธศาสตร์สถาบันมะเร็งแห่งชาติ%20พ.ศ.%202560-2564_27919.pdf
4. Phrapokklao Cancer Center of Excellence. Cancer Registration at Phrapokklao Hospital. Chanthaburi, Thailand: Phrapokklao Hospital; 2020.
5. The International Society of Geriatric Oncology. G8 questionnaire [Internet]. 2010 [cited 2020 July 23]. Available from:http://www.siog.org/files/public/g8_english_0.pdf
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8. Vora N, Reckamp KL. Non-small cell lung cancer in the elderly: defining treatment options. Semin Oncol 2008;35(6):590-6.
9. Wisnivesky JP, Halm E, Bonomi M, Powell C, Bagiella E. Effectiveness of radiation therapy for elderly patients with unresected stage I and II non-small cell lung cancer. Am J Respir Crit Care Med 2010;181(3):264-9.
10. Antonia SJ, Villegas A, Daniel D, Vicente D, Murakami S, Hui R, et al. Overall survival with durvalumab after chemoradiotherapy in stage III NSCLC. N Engl J Med 2018;379(24):2342-50.
11. Jalal SI, Riggs HD, Melnyk A, Richards D, Agarwala A, Neubauer M, et al. Updated survival and outcomes for older adults with inoperable stage III non-small-cell lung cancer treated with cisplatin, etoposide, and concurrent chest radiation with or without consolidation docetaxel: analysis of a phase III trial from the Hoosier Oncology Group (HOG) and US Oncology. Ann Oncol 2012;23(7):1730-8.
12. Lee JH, Wu HG, Kim HJ, Kim DW, Lee SH, Kim TM, et al. Influence of comorbidities on the efficacy of radiotherapy with or without chemotherapy in elderly stage III non-small cell lung cancer patients. Cancer Res Treat 2012;44(4):242-50.
13. Sinha S, Alexader M, Gajra A. Lung Cancer. In: Korc-Grodzicki B, Tew WP, editors. Handbook of geriatric oncology:practical guide to caring for the older cancer patient. New York City, New York State, USA: Demos Medical; 2017. p.161-70.
14. Schiller JH, Harrington D, Belani CP, Langer C, Sandler A, Krook J, et al. Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer. N Engl J Med 2002;346(2):92-8.
15. Sandler A, Gray R, Perry MC, Brahmer J, Schiller JH, Dowlati A, et al. Paclitaxelcarboplatin alone or with bevacizumab for non-small-cell lung cancer. N Engl J Med 2006;14;355(24):2542-50.
16. Ramalingam SS, Dahlberg SE, Langer CJ, Gray R, Belani CP, Brahmer JR, et al. Outcomes for elderly, advanced-stage non small-cell lung cancer patients treated with bevacizumab in combination with carboplatin and paclitaxel: analysis of Eastern Cooperative Oncology Group Trial 4599. J Clin Oncol 2008;26(1):60-5.
17. NCCN. NCCN clinical practice guidelines in oncology: colon cancer [Internet]. 2020 [cited 2020 July 23]. Available from: https:/ /www.nccn.org/professionals/physician_gls/ pdf/nscl.pdf
18. McCleary NJ, Meyerhardt JA, Green E, Yothers G, de Gramont A, Van Cutsem E, et al. Impact of age on the efficacy of newer adjuvant therapies in patients with stage II/ III colon cancer: findings from the ACCENT database. J Clin Oncol 2013;31(20):2600-6.
19. Papamichael D, Audisio RA, Glimelius B, de Gramont A, Glynne-Jones R, Haller D, et al. Treatment of colorectal cancer in older patients: International Society of Geriatric Oncology (SIOG) consensus recommendations 2013. Ann Oncol 2015;26(3):463-76.
20. Shahrokni A. Colorectal cancer. In: Korc-Grodzicki B, Tew WP, editors. Handbook of geriatric oncology: practical guide to caring for the older cancer patient. New York City, New York State, USA: Demos Medical; 2017. p.153-9.
21. Idrees M, Tejani M. Current treatment strategies for elderly patients with metastatic colon cancer. Cureus [Internet]. 2019 [cited 2020 July 31];11(5):e4713. Available from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6650188/
22. Kim JH. Chemotherapyfor colorectal cancer in the elderly. World J Gastroenterol 2015;21(17):5158-66.
23. Hurwitz H, Fehrenbacher L, Novotny W, Cartwright T, Hainsworth J, Heim W, et al. Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med 2004;350(23):2335-42.
24. Zhang G, Zhou X, Lin C. Efficacy of chemotherapy plus bevacizumab as first-line therapy in patients with metastatic colorectal cancer: a meta-analysis and up-date. Int J Clin Exp Med 2015;8(1):1434-45.
25. Koch C, Schwing AM, Herrmann E, Borner M, Diaz-Rubio E, Dotan E, et al. Bevacizumab-based first-line chemotherapy in elderly patients with metastatic colorectal cancer: an individual patient data based meta-analysis. Oncotarget 2017;9(12):10272-83.
26. Lee SY, Seo JH. Current strategies of endocrine therapy in elderly patients with beast cancer. Biomed Res Int [Internet]. 2018 [cited 2020 July 23];doi: 10.1155/2018/6074808. Available from:https://www.hindawi.com/journals/bmri/2018/6074808/
27. Fujii T, Le Du F, Xiao L, Kogawa T, Barcenas CH, Alvarez RH, et al. Effectiveness of an adjuvant chemotherapy regimen for early-stage breast cancer: a systematic review and network meta-analysis. JAMA Oncol 2015;1(9):1311-8.
28. Upshaw JN. Cardio-oncology: protecting the heart from curative breast cancer treatment. Gland Surg 2018;7(4):350-65.
29. Dall P, Lenzen G, Gohler T, Lerchenmu ller C, Feisel-Schwickardi G, Koch T, et al. Trastuzumab in the treatment of elderly patients with early breast cancer: results from an observational study in Germany. J Geriatr Oncol 2015;6(6):462-9.
30. Spring LM, Wander SA, Zangardi M, Bardia A. CDK 4/6 inhibitors in breast cancer:current controversies and future directions. Curr Oncol Rep [Internet]. 2019 [cited 2020 July 23];21(3):25. Available from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC 6573012/
31. Liedtke C, Kolberg HC. Systemic therapy of advanced/metastatic breast cancercurrent evidence and future concepts. Breast Care (Basel) 2016;11(4):275-81.
32. Forner A, Reig M, Bruix J. Hepatocellular carcinoma. Lancet 2018;391(10127):1301-14.
33. Cho E, Cho HA, Jun CH, Kim HJ, Cho SB, Choi SK. A review of hepatocellular carcinoma in elderly patients focused on management and outcomes. In Vivo 2019;33(5):1411-20.
34. Kim DW, Talati C, Kim R. Hepatocellular carcinoma (HCC): beyond sorafenib-chemotherapy. J Gastrointest Oncol 2017;8(2):256-65.
2. Foundation of Thai Gerontology Research and Development Institute. Situation of the Thai elderly 2018. Bangkok, Thailand:Amarin Printing and Publishing; 2018.
3. Ministry of Public Health, National Cancer Institute. National Cancer Institute Strategic Plan 2019-2022 [Internet]. 2018 [cited 31 July 2020]. Available from: http://www.nci.go.th/th/Today/download/แผนยุทธศาสตร์สถาบันมะเร็งแห่งชาติ%20พ.ศ.%202560-2564_27919.pdf
4. Phrapokklao Cancer Center of Excellence. Cancer Registration at Phrapokklao Hospital. Chanthaburi, Thailand: Phrapokklao Hospital; 2020.
5. The International Society of Geriatric Oncology. G8 questionnaire [Internet]. 2010 [cited 2020 July 23]. Available from:http://www.siog.org/files/public/g8_english_0.pdf
6. Rand Health Care. Survey (VES-13) [Internet]. 2020 [cited 2020 July 31]. Available from:https://www.rand.org/health-care/projects/acove/survey.html
7. NCCN. NCCN clinical practice guidelines in oncology: non-small cell lung cancer [Internet]. 2020 [cited 2020 July 23]. Available from:https://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf
8. Vora N, Reckamp KL. Non-small cell lung cancer in the elderly: defining treatment options. Semin Oncol 2008;35(6):590-6.
9. Wisnivesky JP, Halm E, Bonomi M, Powell C, Bagiella E. Effectiveness of radiation therapy for elderly patients with unresected stage I and II non-small cell lung cancer. Am J Respir Crit Care Med 2010;181(3):264-9.
10. Antonia SJ, Villegas A, Daniel D, Vicente D, Murakami S, Hui R, et al. Overall survival with durvalumab after chemoradiotherapy in stage III NSCLC. N Engl J Med 2018;379(24):2342-50.
11. Jalal SI, Riggs HD, Melnyk A, Richards D, Agarwala A, Neubauer M, et al. Updated survival and outcomes for older adults with inoperable stage III non-small-cell lung cancer treated with cisplatin, etoposide, and concurrent chest radiation with or without consolidation docetaxel: analysis of a phase III trial from the Hoosier Oncology Group (HOG) and US Oncology. Ann Oncol 2012;23(7):1730-8.
12. Lee JH, Wu HG, Kim HJ, Kim DW, Lee SH, Kim TM, et al. Influence of comorbidities on the efficacy of radiotherapy with or without chemotherapy in elderly stage III non-small cell lung cancer patients. Cancer Res Treat 2012;44(4):242-50.
13. Sinha S, Alexader M, Gajra A. Lung Cancer. In: Korc-Grodzicki B, Tew WP, editors. Handbook of geriatric oncology:practical guide to caring for the older cancer patient. New York City, New York State, USA: Demos Medical; 2017. p.161-70.
14. Schiller JH, Harrington D, Belani CP, Langer C, Sandler A, Krook J, et al. Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer. N Engl J Med 2002;346(2):92-8.
15. Sandler A, Gray R, Perry MC, Brahmer J, Schiller JH, Dowlati A, et al. Paclitaxelcarboplatin alone or with bevacizumab for non-small-cell lung cancer. N Engl J Med 2006;14;355(24):2542-50.
16. Ramalingam SS, Dahlberg SE, Langer CJ, Gray R, Belani CP, Brahmer JR, et al. Outcomes for elderly, advanced-stage non small-cell lung cancer patients treated with bevacizumab in combination with carboplatin and paclitaxel: analysis of Eastern Cooperative Oncology Group Trial 4599. J Clin Oncol 2008;26(1):60-5.
17. NCCN. NCCN clinical practice guidelines in oncology: colon cancer [Internet]. 2020 [cited 2020 July 23]. Available from: https:/ /www.nccn.org/professionals/physician_gls/ pdf/nscl.pdf
18. McCleary NJ, Meyerhardt JA, Green E, Yothers G, de Gramont A, Van Cutsem E, et al. Impact of age on the efficacy of newer adjuvant therapies in patients with stage II/ III colon cancer: findings from the ACCENT database. J Clin Oncol 2013;31(20):2600-6.
19. Papamichael D, Audisio RA, Glimelius B, de Gramont A, Glynne-Jones R, Haller D, et al. Treatment of colorectal cancer in older patients: International Society of Geriatric Oncology (SIOG) consensus recommendations 2013. Ann Oncol 2015;26(3):463-76.
20. Shahrokni A. Colorectal cancer. In: Korc-Grodzicki B, Tew WP, editors. Handbook of geriatric oncology: practical guide to caring for the older cancer patient. New York City, New York State, USA: Demos Medical; 2017. p.153-9.
21. Idrees M, Tejani M. Current treatment strategies for elderly patients with metastatic colon cancer. Cureus [Internet]. 2019 [cited 2020 July 31];11(5):e4713. Available from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6650188/
22. Kim JH. Chemotherapyfor colorectal cancer in the elderly. World J Gastroenterol 2015;21(17):5158-66.
23. Hurwitz H, Fehrenbacher L, Novotny W, Cartwright T, Hainsworth J, Heim W, et al. Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med 2004;350(23):2335-42.
24. Zhang G, Zhou X, Lin C. Efficacy of chemotherapy plus bevacizumab as first-line therapy in patients with metastatic colorectal cancer: a meta-analysis and up-date. Int J Clin Exp Med 2015;8(1):1434-45.
25. Koch C, Schwing AM, Herrmann E, Borner M, Diaz-Rubio E, Dotan E, et al. Bevacizumab-based first-line chemotherapy in elderly patients with metastatic colorectal cancer: an individual patient data based meta-analysis. Oncotarget 2017;9(12):10272-83.
26. Lee SY, Seo JH. Current strategies of endocrine therapy in elderly patients with beast cancer. Biomed Res Int [Internet]. 2018 [cited 2020 July 23];doi: 10.1155/2018/6074808. Available from:https://www.hindawi.com/journals/bmri/2018/6074808/
27. Fujii T, Le Du F, Xiao L, Kogawa T, Barcenas CH, Alvarez RH, et al. Effectiveness of an adjuvant chemotherapy regimen for early-stage breast cancer: a systematic review and network meta-analysis. JAMA Oncol 2015;1(9):1311-8.
28. Upshaw JN. Cardio-oncology: protecting the heart from curative breast cancer treatment. Gland Surg 2018;7(4):350-65.
29. Dall P, Lenzen G, Gohler T, Lerchenmu ller C, Feisel-Schwickardi G, Koch T, et al. Trastuzumab in the treatment of elderly patients with early breast cancer: results from an observational study in Germany. J Geriatr Oncol 2015;6(6):462-9.
30. Spring LM, Wander SA, Zangardi M, Bardia A. CDK 4/6 inhibitors in breast cancer:current controversies and future directions. Curr Oncol Rep [Internet]. 2019 [cited 2020 July 23];21(3):25. Available from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC 6573012/
31. Liedtke C, Kolberg HC. Systemic therapy of advanced/metastatic breast cancercurrent evidence and future concepts. Breast Care (Basel) 2016;11(4):275-81.
32. Forner A, Reig M, Bruix J. Hepatocellular carcinoma. Lancet 2018;391(10127):1301-14.
33. Cho E, Cho HA, Jun CH, Kim HJ, Cho SB, Choi SK. A review of hepatocellular carcinoma in elderly patients focused on management and outcomes. In Vivo 2019;33(5):1411-20.
34. Kim DW, Talati C, Kim R. Hepatocellular carcinoma (HCC): beyond sorafenib-chemotherapy. J Gastrointest Oncol 2017;8(2):256-65.
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2021-01-26
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