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老年肝癌患者系统治疗策略OACSTPCD

Systemic Treatment Strategies for Elderly Patients with Hepatocellular Carcinoma

中文摘要英文摘要

衰老是促进慢性肝病不同阶段发展的主要风险因素,与肝细胞癌的发生密切相关,老年和年轻肝癌患者的临床病理学特征及肿瘤微环境有显著区别.肝癌系统治疗领域发展日新月异,免疫检查点抑制剂联合靶向治疗极大改善了晚期肝癌患者的预后.老年肝癌患者治疗决策的选择需要考虑年龄相关的独特问题,在决策前需进行充分沟通和必要评估.通过大型临床研究的年龄亚组分析,可以推测老年肝癌患者能够从免疫联合治疗中获益,不应将高龄作为治疗策略选择的限制因素.然而,将临床试验中获得的疗效和安全性数据外推到真实世界中的老年人群具有一定局限性,针对老年肝癌患者的最佳诊疗方案仍有待大规模前瞻性临床研究进一步探索.

Senescence is the major risk factor that promotes development of different stages of chronic liver diseases and is closely related to occurrence of hepatocellular carcinoma.Significant differences consist in clinicopathological features and tumor microenvironment between elderly and young patients with hepatocellular carcinoma.With rapid development of systemic therapy,immune checkpoint inhibitors combined with targeted therapy have greatly improved the prognosis of patients with advanced hepa-tocellular carcinoma.The selection of treatment decisions for elderly patients with hepatocellular carcinoma requires to consider u-nique age-related issues.Adequate communication and necessary evaluation should be carried out before making decisions.Elderly patients with hepatocellular carcinoma are speculated to benefit from combination immunotherapy based on age subgroup analysis of large clinical studies.However,data of effects and security obtained from clinical trials has certain limitations when being ap-plied in elderly populations of real world.The optimal therapeutic strategies for elderly patients with hepatocellular carcinoma still remain to be further explored in large-scale prospective clinical studies.

孙伊婷;滕赞;刘云鹏;曲秀娟

中国医科大学附属第一医院肿瘤内科,沈阳 110000||辽宁省肿瘤药物与生物治疗重点实验室,沈阳 110000||辽宁省恶性肿瘤临床医学研究中心,沈阳 110000

临床医学

肝癌患者/老年系统治疗策略免疫检查点抑制剂

Hepatocellular carcinoma patients/elderlySystematic treatment strategiesImmune checkpoint inhibitors

《医药导报》 2024 (003)

374-379 / 6

沈阳市恶性肿瘤综合治疗临床医学研究中心(2021年沈阳市科技创新平台).

10.3870/j.issn.1004-0781.2024.03.007

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