老年患者是非小细胞肺癌（non-small cell lungcancer， NSCLC）的主要患病人群。由于年龄因素，老年患者多 器官储备下降，并发症的发生率较高，导致其耐受性较年轻患者低，治疗方案选择受到限制。因此，针对老年晚期NSCLC 患者身体状况的有效评估和治疗方案的选择成为目前的挑战和人们关注的焦点。老年晚期非小细胞肺癌患者的系统性治疗 如化疗、靶向治疗和免疫治疗，已被逐步研究并取得突破性进展。整体上，对于化疗，在老年人中进行的多项临床试验显 示，以铂类为基础的双药联合治疗取得令人满意的结果；对于抗血管生成剂，目前并没有足够的证据表明其可在老年晚期 NSCLC 患者中安全应用；TKI 药物在携带特定驱动突变的老年患者中表现出良好的应答和耐受性，但特定基因突变在老年 患者中发生频率明显低；免疫检查点抑制剂通过改善肿瘤患者免疫状态的策略在老年患者中也获得一定的疗效，因此年龄 不应该成为衡量是否接受免疫治疗的唯一因素。本文主要对老年人群系统性治疗的最新研究进展和相关指南推荐进行系列 综述，希望在指导老年患者治疗方案的选择上提供借鉴。

Elderly patients are the main group for non-small cell lung cancer (NSCLC). Due to the increased age, the multi-organ reserve of elderly patients decrease, the incidence of comorbidities is higher, resulting in lower tolerance than younger patients, and the choice of treatment options is limited. Therefore, the effective assessment of the physical condition of elderly patients with advanced NSCLC and the choice of treatment options have become the current challenges and the focus of attention. Systemic treatment of elderly patients, such as chemotherapy, targeted therapy and immunotherapy for advanced NSCLC, has been gradually studied and made breakthrough progress. Overall, for chemotherapy, a number of clinical trials conducted in the elderly have shown satisfactory results with platinum-based combination therapy; for anti-angiogenic agents, there is currently insufficient evidence to show the safe use in elderly patients; TKI drugs show good response and tolerability in elderly patients with specific driver mutations, but specific driven gene mutations occur less frequently in older patients; immune checkpoint inhibitors, the strategy of which is to improve the immune status of cancer patients, also achieves effect in elderly patients to a certain extent, so age should not be the only factor to measure whether to receive immunotherapy. This paper reviews the latest research progress and related guidelines for systemic treatment of the elderly population, and hopes to provide a reference for guiding the choice of treatment options for elderly patients.