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• W4254752010 abstract "L’âge médian de diagnostic d’un cancer bronchique se situe, selon les pays, entre 65 et 70 ans. Pourtant, peu de recommandations sur la prise en charge des personnes âgées existent. Il faut tenir compte de l’état général, mais aussi des comorbidités, des variations physiologiques liées à l’âge, des principales fonctions de l’organisme ainsi que des traitements pris au long cours. Pour les stades précoces de cancer bronchique non à petites cellules, l’indication chirurgicale doit être discutée. La chimiothérapie adjuvante n’est pas indiquée après 75 ans. Dans les formes localement avancées on privilégiera l’administration séquentielle de la chimiothérapie et de la radiothérapie. Dans les formes métastatiques, lorsqu’il existe des mutations ciblables, une thérapie ciblée doit être mise en œuvre quel que soit le PS. Pour les formes non mutées et les épidermoïdes, le traitement sera un doublet carboplatine-paclitaxel hebdomadaire pour les patients de PS 0-2. Les inhibiteurs de points de contrôle de l’immunité ont été investigués en première et en deuxième ligne et des personnes âgées font partie des essais mais il n’y a pas d’essai dédié. En ce qui concerne le cancer bronchique à petites cellules, le traitement reste l’association carboplatine + étoposide. Median age at diagnosis of lung cancer is between 65-70 years according to the countries However, specific recommendations about their management regarding are scant. It is mandatory to take into account not only the Performance status (PS) but also comorbidities, age-related physiological variations of the main body functions, or polypharmacy. Regarding early stages of non-small-cell lung cancer, surgery must be discussed. Adjuvant chemotherapy is not recommended after 75 years. For locally advanced non-small cell lung cancer, sequential chemotherapy and radiotherapy is proposed. For metastatic stages, in cases of targetable mutations, targeted therapies are recommended whatever the Performance Status, the doublet carboplatine (not cisplatin) plus etoposide remains the standard in elderly patients. In case of the absence of targetable mutations or squamous cell carcinoma, a carboplatine-based doublet (mainly with weekly paclitaxel) can be used in patients with PS 0-2. The role of checkpoint inhibitors has been investigated in first line therapy and second line therapy with elderly patients included in the trials but there has been no specific study. Regarding small-cell lung cancer, the doublet carboplatine+etoposide remains standard." @default.
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• W4254752010 date "2018-10-01" @default.
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• W4254752010 title "Les populations particulières : les personnes âgées atteintes d’un cancer bronchique" @default.
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• W4254752010 doi "https://doi.org/10.1016/s1877-1203(18)30038-7" @default.
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