Monfardini Silvio, Aapro M S, Bennett J M, Mori M, Regenstreif D, Rodin M, Stein B, Zulian G B, Droz J P
Department of Medical Oncology, Istituto Oncologico Veneto, via Gattamelata 64, 35128 Padova, Italy.
Crit Rev Oncol Hematol. 2007 Apr;62(1):62-73. doi: 10.1016/j.critrevonc.2006.10.003. Epub 2007 Feb 14.
Management for elderly cancer patients world wide is far from being optimal and few older patients are entering clinical trials. A SIOG Task Force was therefore activated to analyze how the clinical activity of Geriatric Oncology is organized. A structured questionnaire was circulated among the SIOG Members. Fifty eight answers were received. All respondents identified Geriatric Oncology, as an area of specialization, however the organization of the clinical activity was variable. Comprehensive Geriatric Assessment (CGA) was performed in 60% of cases. A Geriatric Oncology Program (GOP) was identified in 21 centers, 85% located in Oncology and 15% in Geriatric Departments. In the majority of GOP scheduled case discussion conferences dedicated to elderly cancer patients took regular place, the composition of the multidisciplinary team involved in the GOP activity included Medical Oncologists, Geriatricians, Nurses, Pharmacists, Social Workers. Fellowships in Geriatric Oncology were present in almost half of GOPs. Over 60% of respondents were willing to recruit patients over 70 years in clinical trials, while the proportion of cases included was only 20%. Enrolment in clinical trials was perceived as more difficult by 52% and much more difficult in 12% of the respondents. In conclusion, a better organization of the clinical activity in Geriatric Oncology allows a better clinical practice and an optimal clinical research. The GOP which can be set up in the oncological as well as in the geriatric environment thought a multidisciplinary coordinator effort. Future plans should also concentrate on divisions, units or departments of Geriatric Oncology.
全球老年癌症患者的管理远未达到最佳状态，很少有老年患者参与临床试验。因此，国际老年肿瘤学会（SIOG）启动了一个特别工作组来分析老年肿瘤学的临床活动是如何组织的。一份结构化问卷在SIOG成员中进行了分发。共收到58份回复。所有受访者都将老年肿瘤学视为一个专业领域，然而临床活动的组织方式各不相同。60%的病例进行了综合老年评估（CGA）。在21个中心确定了老年肿瘤学项目（GOP），其中85%位于肿瘤科，15%位于老年科。在大多数GOP中，定期举行专门针对老年癌症患者的病例讨论会，参与GOP活动的多学科团队成员包括医学肿瘤学家、老年病学家、护士、药剂师、社会工作者。几乎一半的GOP设有老年肿瘤学奖学金。超过60%的受访者愿意招募70岁以上的患者参加临床试验，而实际纳入的病例比例仅为20%。52%的受访者认为临床试验的入组比较困难，12%的受访者认为非常困难。总之，更好地组织老年肿瘤学的临床活动有助于改善临床实践和优化临床研究。通过多学科协调努力，可以在肿瘤学和老年医学环境中设立GOP。未来的计划也应集中在老年肿瘤学的科室、单元或部门。
