Department of General Medical Oncology and Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium.
Ann Oncol. 2013 May;24(5):1306-12. doi: 10.1093/annonc/mds619. Epub 2013 Jan 4.
To evaluate the large-scale feasibility and usefulness of geriatric screening and assessment in clinical oncology practice by assessing the impact on the detection of unknown geriatric problems, geriatric interventions and treatment decisions.
Eligible patients who had a malignant tumour were ≥70 years old and treatment decision had to be made. Patients were screened using G8; if abnormal (score ≤14/17) followed by Comprehensive Geriatric Assessment (CGA). The assessment results were communicated to the treating physician using a predefined questionnaire to assess the topics mentioned above.
One thousand nine hundred and sixty-seven patients were included in 10 hospitals. Of these patients, 70.7% had an abnormal G8 score warranting a CGA. Physicians were aware of the assessment results at the time of treatment decision in two-thirds of the patients (n = 1115; 61.3%). The assessment detected unknown geriatric problems in 51.2% of patients. When the physician was aware of the assessment results at the time of decision making, geriatric interventions were planned in 286 patients (25.7%) and the treatment decision was influenced in 282 patients (25.3%).
Geriatric screening and assessment in older patients with cancer is feasible at large scale and has a significant impact on the detection of unknown geriatric problems, leading to geriatric interventions and adapted treatment.
通过评估对未知老年问题的检出、老年干预和治疗决策的影响，来评估在临床肿瘤学实践中进行老年综合评估的大规模可行性和实用性。
符合条件的恶性肿瘤患者年龄≥70 岁且必须做出治疗决策。使用 G8 对患者进行筛选；如果异常（评分≤14/17），则进行全面老年评估（CGA）。使用预定的问卷将评估结果传达给治疗医生，以评估上述主题。
10 家医院共纳入 1967 例患者。这些患者中，70.7%的 G8 评分异常，需要进行 CGA。在三分之二的患者（n=1115；61.3%）中，医生在治疗决策时就已经了解了评估结果。评估在 51.2%的患者中发现了未知的老年问题。当医生在决策时了解评估结果时，计划对 286 例患者（25.7%）进行老年干预，并对 282 例患者（25.3%）的治疗决策产生影响。
在老年癌症患者中进行老年综合评估具有大规模可行性，对发现未知老年问题具有显著影响，从而导致老年干预和治疗决策的调整。
