Extermann Martine, Aapro Matti, Bernabei Roberto, Cohen Harvey Jay, Droz Jean-Pierre, Lichtman Stuart, Mor Vincent, Monfardini Silvio, Repetto Lazzaro, Sørbye Liv, Topinkova Eva
H. Lee Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA.
Crit Rev Oncol Hematol. 2005 Sep;55(3):241-52. doi: 10.1016/j.critrevonc.2005.06.003.
As more and more cancers occur in elderly people, oncologists are increasingly confronted with the necessity of integrating geriatric parameters in the treatment of their patients.
The International Society of Geriatric Oncology (SIOG) created a task force to review the evidence on the use of a comprehensive geriatric assessment (CGA) in cancer patients. A systematic review of the evidence was conducted.
Several biological and clinical correlates of aging have been identified. Their relative weight and clinical usefulness is still poorly defined. There is strong evidence that a CGA detects many problems missed by a regular assessment in general geriatric and in cancer patients. There is also strong evidence that a CGA improves function and reduces hospitalization in the elderly. There is heterogeneous evidence that it improves survival and that it is cost-effective. There is corroborative evidence from a few studies conducted in cancer patients. Screening tools exist and were successfully used in settings such as the emergency room, but globally were poorly tested. The article contains recommendations for the use of CGA in research and clinical care for older cancer patients.
A CGA, with or without screening, and with follow-up, should be used in older cancer patients, in order to detect unaddressed problems, improve their functional status, and possibly their survival. The task force cannot recommend any specific tool or approach above others at this point and general geriatric experience should be used.
随着越来越多的癌症发生在老年人身上，肿瘤学家在治疗患者时越来越有必要将老年医学参数纳入考量。
国际老年肿瘤学会（SIOG）成立了一个特别工作组，以审查在癌症患者中使用综合老年评估（CGA）的证据。对相关证据进行了系统回顾。
已确定了衰老的一些生物学和临床相关因素。它们的相对权重和临床实用性仍定义不清。有强有力的证据表明，CGA能发现一般老年患者和癌症患者常规评估遗漏的许多问题。也有强有力的证据表明，CGA可改善老年人的功能并减少住院率。关于CGA能提高生存率和具有成本效益的证据参差不齐。在癌症患者中进行的一些研究提供了佐证。筛查工具存在，并在急诊室等环境中成功使用，但总体测试不足。本文包含了在老年癌症患者的研究和临床护理中使用CGA的建议。
无论是否进行筛查以及是否进行随访，都应在老年癌症患者中使用CGA，以便发现未解决的问题，改善其功能状态，并可能提高其生存率。特别工作组目前无法推荐任何一种特定工具或方法优于其他工具或方法，应借鉴一般老年医学经验。
