| Popis: |
Western world is rapidly aging, yet the exact threshold age for differentiating elderly versus non-elderly is not widely adopted. Elderly are also underrepresented in clinical trials and level of evidence of preferred treatment in both non-small-cell and small-cell lung cancer is basically lacking. From the existing evidence, however, it seems that radiation therapy is safe and effective treatment modality in patients with early stage non-small-cell lung cancer. It is so also in locally advanced non-small-cell lung cancer when combined with radiochemotherapy, although caution should be exercised when one attempts to combine high-dose radiation therapy with high-dose chemotherapy. Similarly, palliative radiation therapy is effective in elderly with non-small-cell lung cancer unsuitable for radical approach, with or without additional chemotherapy. Finally, in small-cell lung cancer, again, radiation therapy can successfully be employed either alone or, most frequently, with chemotherapy in treatment of both limited and extensive-disease small-cell lung cancer. While largely unsubstantiated fear has governed our approaches in elderly with lung cancer in recent decades, novel radiation therapy technologies and novel drugs should provide suitable framework for embarking on more clinical trials in elderly. |
