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Möglichkeiten und Grenzen der onkologischen Chemotherapie bei alten Patienten

Chances and limitations of chemotherapy in elderly patients

  • Arzneimitteltherapie
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Zusammenfassung

Das chronologische Alter eines Patienten ist keine Grenze für die Durchführung einer Chemotherapie, denn auch alte Menschen können von einer Chemotherapie profitieren. Ein diagnostischer und therapeutischer Nihilismus allein aufgrund des Alters eines Patienten ist daher nicht gerechtfertigt. Allerdings stehen nur wenige Daten mit hohem Evidenzlevel zur Behandlung alter Patienten mit Krebserkrankungen zur Verfügung. Das chronologische Alter allein ist kein hinreichendes Kriterium für die Beschreibung des gesundheitlichen Zustands eines Patienten. Ein systematisches geriatrisches Assessment bildet die individuellen Defizite und Ressourcen sehr viel besser ab. Die hier abgebildeten Einschränkungen sind Risikofaktoren für das Auftreten von Toxizitäten und für einen geringeren Behandlungsvorteil im Rahmen der Chemotherapie. Die zur Verfügung stehenden Daten sprechen dafür, dass es sowohl eine Unter- als auch eine Übertherapie gibt.

Abstract

The chronological age of a patient should not be a barrier to apply chemotherapy. Elderly patients can benefit from chemotherapy. Chronological age should not be a reason for diagnostic or therapeutic nihilism, as the age of a patient poorly characterizes their health situation. Data with high level of evidence on treatment of elderly patients with cancer are limited. A comprehensive geriatric assessment (CGA) describes the individual deficits and resources of a patient much better. Limitations in CGA are risk factors for increased toxicity and decreased treatment benefit. The currently available data demonstrate under- and over-treatment in elderly patients with cancer.

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  1. Klinik für Innere Medizin II, Abteilung Palliativmedizin, Universitätsklinikum Jena, Erlanger Allee 101, 07747, Jena, Deutschland

    U. Wedding

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Wedding, U. Möglichkeiten und Grenzen der onkologischen Chemotherapie bei alten Patienten. Internist 51, 402–409 (2010). https://doi.org/10.1007/s00108-010-2601-x

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