With the accelerating trend of population aging, the number of elderly patients with lung cancer continues to rise, and the disease burden is becoming increasingly heavy. The clinical management of these patients faces severe challenges due to their decreased physiological reserve, complex comorbidities, and significant individual heterogeneity. Consequently, under traditional diagnosis and treatment models, doctors often struggle to identify the individualized risks of elderly patients in a timely and comprehensive manner, which can easily lead to decision biases such as undertreatment or overtreatment. In view of this, this study advocates for the establishment of an umbrella decision-making model specifically tailored for elderly lung cancer patients. Grounded in a multidisciplinary team (MDT) platform, this model deeply integrates oncological indicators with the comprehensive geriatric assessment (CGA) system. By holistically considering multidimensional variables including tumor burden, organ function, frailty index, cognitive status, and social support, the model establishes an operational mechanism characterized by "single entry, precise stratification, and targeted selection". Accordingly, patients can be scientifically triaged into distinct intervention tiers, such as active surveillance, minimally invasive surgery, drug therapy, radiotherapy, and best supportive care, thereby achieving real-time alignment between treatment intensity and patient fitness. This article elaborates on the construction logic and key operational procedures of this novel decision-making framework, aiming to guide clinical practice beyond the limitations of a tumor-centric perspective toward a holistic, dynamic, whole-course management strategy. This transition seeks to ensure optimal quality of life and clinical net benefit for elderly patients alongside survival prolongation.

Objective:To evaluate the influence of ankle acupuncture on the cognitive impairment caused by sevoflurane in elderly rats and the expression of hippocampal phosphorylated phospholipase Cγ (p-PLCγ).Methods:Fifteen SPF-grade healthy male Sprague-Dawley rats, aged 18 months, weighing 530-600 g, were allocated into 3 groups ( n=5 each) using a random number table method: sham surgery group (S group), cognitive dysfunction group (CD group) and ankle acupuncture group (A group). The cognitive dysfunction model was prepared by inhaling the mixture of 3% sevoflurane and air, with ankle acupuncture applied to the right hind limb 1-3 region for 30 min prior to anesthesia in A group. S group received sham stimulation. Two days later, the cognitive function was assessed using the Morris water maze test. The rats were subsequently sacrificed and hippocampal tissues were collected for microscopic examination of the pathological changes (using HE staining and Nissl staining) and for determination of the expression of p-PLCγ, phosphorylated calcium/calmodulin-dependent protein kinase Ⅱ (p-CaMKⅡ) and phosphorylated inositol-1, 4, 5-trisphosphate receptor (p-IP3R). Results:Compared with S group, the escape latency was significantly prolonged, the number of crossing the original platform quadrant was reduced, and the expression of p-PLCγ, p-CaMKII and p-IP3R was up-regulated in CD group and A group ( P<0.05). Compared with CD group, the escape latency was significantly shortened, the number of crossing the original platform quadrant was increased, and the expression of p-PLCγ, p-CaMKII and p-IP3R was down-regulated in A group ( P<0.05). The pathological changes were significantly reduced in A group compared with CD group. Conclusions:Ankle acupuncture can ameliorate cognitive dysfunction induced by sevoflurane in elderly rats, and the mechanism is related to inhibition of hippocampal p-PLCγ expression.