Marenco D, Marinello R, Berruti A, Gaspari F, Stasi M F, Rosato R, Bertetto O, Molaschi M, Ciccone G
Department of Medical Oncology, ASO S. Giovanni Battista, Turin, Italy.
Crit Rev Oncol Hematol. 2008 Nov;68(2):157-64. doi: 10.1016/j.critrevonc.2008.07.003. Epub 2008 Aug 23.
This prospective cohort study of consecutive elderly cancer patients was undertaken to evaluate the role of the multidimensional geriatric assessment (MGA) as an aid in treatment decision-making. A total of 571 cancer patients (aged > or =70) were enrolled during 6-year (1999-2005). All underwent MGA as part of the first evaluation. In multivariate analysis, the probability of receiving active, instead of palliative, treatment was negatively associated with increasing age (odds ratio=0.69 every 5 years, p=0.005), living alone (OR=0.54, p=0.031), dependence in activities of daily living (ADL score >0, OR=0.41, p=0.003) and a low body-mass index (BMI) (OR=0.51, p=0.061); while a positive association emerged for instrumental activities of daily living (IADL) score (OR=1.12 per point, p=0.019). Our data suggest that MGA, in addition to age, is a useful tool in clinical practice for deciding cancer treatment in elderly patients, with a major independent role played by living alone, ADL, IADL and BMI.
这项针对连续老年癌症患者的前瞻性队列研究旨在评估多维老年评估（MGA）在辅助治疗决策中的作用。在6年期间（1999 - 2005年）共纳入了571例癌症患者（年龄≥70岁）。所有患者在首次评估时均接受了MGA。在多变量分析中，接受积极治疗而非姑息治疗的概率与年龄增长（每5年比值比 = 0.69，p = 0.005）、独居（OR = 0.54，p = 0.031）、日常生活活动依赖（ADL评分＞0，OR = 0.41，p = 0.003）以及低体重指数（BMI）（OR = 0.51，p = 0.061）呈负相关；而与日常生活工具性活动（IADL）评分呈正相关（每分OR = 1.12，p = 0.019）。我们的数据表明，除年龄外，MGA是临床实践中决定老年患者癌症治疗的有用工具，独居、ADL、IADL和BMI起着主要的独立作用。
