Mohile Supriya G, Magnuson Allison
School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY 14642, USA.
Interdiscip Top Gerontol. 2013;38:85-103. doi: 10.1159/000343608. Epub 2013 Jan 17.
The incidence of cancer increases with advanced age and the majority of cancer deaths are in patients aged ≥ 65. The geriatric population is a heterogeneous group and a patient's chronologic age does not always correlate with underlying physiologic status. Oncologists need to be able to obtain information on physiologic and functional capacity in older patients in order to provide safe and effective treatment recommendations. The Comprehensive Geriatric Assessment (CGA) is a compilation of validated tools that predict morbidity and mortality in community-dwelling older adults. The various components of the CGA have also been shown to influence clinical decision-making and predict outcomes in older cancer patients. The combined data from the CGA can be used to stratify patients into risk categories to better predict their tolerance to treatment and risk for chemotherapy toxicity. However, the CGA is a comprehensive tool requiring significant time and training to perform. A variety of screening tools have been developed which may be useful in the general oncology practice setting to identify patients that may benefit from further testing and intervention. This chapter will review the components and predictive value of CGA in older cancer patients, with emphasis on how CGA can practically be incorporated into clinical practice.
癌症发病率随年龄增长而升高，大多数癌症死亡病例发生在65岁及以上的患者中。老年人群是一个异质性群体，患者的实际年龄并不总是与潜在的生理状态相关。肿瘤学家需要能够获取老年患者生理和功能能力的信息，以便提供安全有效的治疗建议。综合老年评估（CGA）是一套经过验证的工具，可预测社区居住的老年人的发病率和死亡率。CGA的各个组成部分也已被证明会影响临床决策，并预测老年癌症患者的预后。CGA的综合数据可用于将患者分层为风险类别，以更好地预测他们对治疗的耐受性和化疗毒性风险。然而，CGA是一个全面的工具，执行起来需要大量时间和培训。已经开发了各种筛查工具，这些工具在一般肿瘤学实践环境中可能有助于识别可能从进一步检测和干预中受益的患者。本章将回顾CGA在老年癌症患者中的组成部分和预测价值，重点是如何将CGA实际纳入临床实践。
