University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Thomas Jefferson University, Philadelphia, PA, USA.
J Geriatr Oncol. 2016 Jul;7(4):249-57. doi: 10.1016/j.jgo.2015.12.002. Epub 2015 Dec 22.
Comorbidity is an issue of growing importance due to changing demographics and the increasing number of adults over the age of 65 with cancer. The best approach to the clinical management and decision-making in older adults with comorbid conditions remains unclear. In May 2015, the Cancer and Aging Research Group, in collaboration with the National Cancer Institute and the National Institute on Aging, met to discuss the design and implementation of intervention studies in older adults with cancer. A presentation and discussion on comorbidity measurement, interventions, and future research was included. In this article, we discuss the relevance of comorbidities in cancer, examine the commonly used tools to measure comorbidity, and discuss the future direction of comorbidity research. Incorporating standardized comorbidity measurement, relaxing clinical trial eligibility criteria, and utilizing novel trial designs are critical to developing a larger and more generalizable evidence base to guide the management of these patients. Creating or adapting comorbidity management strategies for use in older adults with cancer is necessary to define optimal care for this growing population.
合并症是一个日益重要的问题，这是由于人口结构的变化以及 65 岁以上患有癌症的成年人数量不断增加所导致的。对于合并症患者的临床管理和决策，最佳方法仍不明确。2015 年 5 月，癌症与老龄化研究小组与美国国立卫生研究院和美国国家老龄化研究所合作，开会讨论了在老年癌症患者中开展干预研究的设计和实施。会上包括了合并症测量、干预措施和未来研究的介绍和讨论。在这篇文章中，我们讨论了合并症在癌症中的相关性，检查了常用的合并症测量工具，并讨论了合并症研究的未来方向。纳入标准化的合并症测量、放宽临床试验资格标准以及利用新的试验设计，对于为这些患者提供管理指导，开发更大和更具普遍性的循证基础至关重要。为了确定针对这一不断增长的人群的最佳护理，有必要为老年癌症患者制定或改编合并症管理策略。
