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老年癌症患者健康状况评估

Assessment of health status in elderly patients with cancer.

作者信息

Kaźmierska Joanna

机构信息

Radiotherapy Department II, Greater Poland Cancer Center, Poznan, Poland ; Electroradiology Department, University of Medical Sciences, Poznan, Poland.

出版信息

Rep Pract Oncol Radiother. 2012 Aug 9;18(1):44-8. doi: 10.1016/j.rpor.2012.07.007. eCollection 2012.

Abstract

BACKGROUND

Health status assessment of senior adults is one of the most important aspects of a treatment decision making process. A group of elderly cancer patients is very heterogeneous according to the health status - some of them are fit enough for aggressive treatment, but others are frail and vulnerable. Treatment for the latter group has to be adapted and carefully monitored.

AIM

To review and analyze relevant literature on the usage and optimization of Comprehensive Geriatric Assessment (CGA).

MATERIALS AND METHODS

Medline search of studies published between 2000 and 2011, containing key words: Comprehensive Geriatric Assessment, aging, cancer in senior adults, frailty.

RESULTS

To recognize and address individual needs of senior adults, a special holistic approach has been developed - comprehensive geriatric assessment (CGA). This tool is a gold standard in gerontooncology, recommended by International Society of Geriatric Oncology. CGA evaluates all important health domains, from physiology to social and economical problems, using sets of different tests. Assessment has to be performed by a trained team, including a physician, nurse and social worker. CGA has been clinically validated in many studies, but it is still not clear whether CGA improves the outcome of treatment of the elderly with cancer.

CONCLUSIONS

Complexity and multidimensionality of CGA pose a logistic challenge for everyday clinical practice. Special senior programs, which could be developed inside comprehensive cancer center, focusing attention on seniors' problems and needs seem to be a way forward for geriatric oncology.

摘要

背景

老年人健康状况评估是治疗决策过程中最重要的方面之一。老年癌症患者群体在健康状况方面差异很大——其中一些人身体状况足以接受积极治疗,但另一些人则体弱且易受伤害。后一组患者的治疗必须进行调整并仔细监测。

目的

回顾和分析关于综合老年评估(CGA)的使用和优化的相关文献。

材料与方法

对2000年至2011年间发表的研究进行医学文献数据库检索,关键词包括:综合老年评估、衰老、老年癌症、虚弱。

结果

为了识别和满足老年人的个体需求,已经开发出一种特殊的整体方法——综合老年评估(CGA)。该工具是老年肿瘤学的金标准,受到国际老年肿瘤学会的推荐。CGA使用不同的测试集评估从生理到社会和经济问题等所有重要的健康领域。评估必须由一个经过培训的团队进行,包括医生、护士和社会工作者。CGA在许多研究中已得到临床验证,但CGA是否能改善老年癌症患者的治疗结果仍不清楚。

结论

CGA的复杂性和多维度性给日常临床实践带来了后勤方面的挑战。在综合癌症中心内部制定专门针对老年人的项目,关注老年人的问题和需求,似乎是老年肿瘤学发展的方向。

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