Oncology Frontier:  Your talk posed the question: “Chemotherapy for Older Patients with Breast Cancer: Should We Use More or Less?” Because of impaired function of major organs and the presence of co-morbidities， “less” seems to be the right answer to this question. Do you have different views on that?

　　《肿瘤瞭望》：您的演讲提出了一个问题：“老年乳腺癌的化疗：应该多还是少”。由于身体重要脏器功能的衰退和共病的问题，“少”似乎是正确答案。对此，您会有不一样的解释吗？

　　Dr Muss: I don’t think it’s about “more” or “less”. It’s about treating a patient according to their goals of treatment， life expectancy and the benefits chemotherapy is going to provide. For older people who are already frail or who have other problems， giving them potent chemotherapy regimens is not likely to make them live longer and can be very toxic. Most younger people do not have comorbidities associated with older age (diabetes， heart disease， emphysema， stroke). For older people who are otherwise healthy and who historically， have been undertreated with chemotherapy who might indeed benefit， they should be given all the options available.

　　Muss教授：我并不认为这是“多”或“少”的问题。这其实是按照患者的治疗目标、预期寿命和化疗获益来治疗患者的问题。对于身体状况极差或存在其他问题的患者，给予她们强力的化疗方案可能不会使她们获得更长，相反可能具有很大毒性。大部分年轻患者不伴有老年人常见的共病（如糖尿病、心脏疾病、肺气肿、卒中）。而健康的老年患者，以及可能真的能从化疗中获益，但既往却治疗不足的患者，可以用现有的所有方案进行治疗。