Département Universitaire de Médecine Générale, Faculté Toulouse Rangueil, Toulouse, France.
J Nutr Health Aging. 2013;17(5):473-8. doi: 10.1007/s12603-012-0435-z.
Increased life expectancy and cancer incidence imply the need to develop a specialized care policy for elderly patients with cancer. We created an oncogeriatric consulting team (OGCT) in Toulouse University Hospital to carry out comprehensive gerontological assessment at the bedside of hospitalized patients. We analyze the impact on the final cancer treatment decision of this mobile geriatric assessment. We carried out a descriptive, retrospective real-life analysis of a patient cohort over a two-year period. The OGCT assessed 124 patients, of whom the majority were women (54.8%), median age 81 years, living at home (95.2%) and with family caregivers (86.5%). Nearly all were frail (96.7% according to the classification of Balducci and colleagues) and 3.2% were vulnerable. The team's decisions were analyzed for patients who had not yet been treated (n=107). After analysis, the team's proposal was in line with the initial cancer treatment plan in 68.2% of cases (n=73). In cases where there was a disagreement, the final decision was in line with the mobile team's proposal in 17.75% of 107 patients (n=19). The decision of the team was followed more often when their assessment proposed strictly palliative treatment. The decision to give elderly patients specific cancer treatment seems in our experience rather to be a matter for the oncologists, and is not very susceptible to modification by geriatric opinion. On the other hand, the geriatrician appears to be more credible and his/her opinion more likely to be followed when the patient is considered too frail and less aggressive, or even exclusively palliative, treatment is proposed.
预期寿命的延长和癌症发病率的增加意味着需要为老年癌症患者制定专门的护理政策。我们在图卢兹大学医院创建了一个肿瘤老年病学咨询团队（OGCT），以便在住院患者床边进行全面的老年病学评估。我们分析了这种移动老年评估对最终癌症治疗决策的影响。我们对两年期间的患者队列进行了描述性、回顾性真实分析。OGCT 评估了 124 名患者，其中大多数是女性（54.8%），中位年龄 81 岁，居住在家庭中（95.2%）并由家庭护理人员照顾（86.5%）。几乎所有患者都很虚弱（根据 Balducci 等人的分类，96.7%），3.2%的患者很脆弱。分析了尚未接受治疗的患者（n=107）的 OGCT 决策。分析后，团队的建议与最初的癌症治疗计划一致，在 68.2%的病例中（n=73）。在意见不一致的情况下，最终决定与移动团队的建议一致，在 107 名患者中的 17.75%（n=19）。当团队评估建议严格进行姑息治疗时，其决策被遵循的频率更高。在我们的经验中，决定为老年患者提供特定的癌症治疗方案似乎更多地取决于肿瘤学家，并且不太容易受到老年医学意见的改变。另一方面，当患者被认为过于虚弱且治疗方案不太积极甚至仅为姑息治疗时，老年病学家似乎更有公信力，其意见更有可能被采纳。
