Department of Radiation Oncology, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Canada.
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.
Clin Oncol (R Coll Radiol). 2018 Sep;30(9):578-588. doi: 10.1016/j.clon.2018.04.008. Epub 2018 May 18.
Comprehensive geriatric assessment (CGA) is a multidisciplinary diagnostic process that evaluates medical, psychological, social and functional capacity. No systematic review of the use of CGA in radiation oncology has been conducted. This paper reviews the use of CGA in radiation oncology, examines whether such assessments are feasible and evaluates the effectiveness of these assessments in predicting and modifying outcomes.
We searched Medline, EMBASE, PsycINFO, CINAHL and the Cochrane Library for articles published between 1 January 1996 and 24 January 2017.
Twelve non-randomised studies were identified; four studies used a geriatric screening tool only and the eight other studies combined a screening tool with a CGA. Most studies had small samples (mean 63 participants). Two studies identified a significant (95% confidence interval 1.5-4.8 and 1.5-6.9) association between an abnormal screening and increased risk of mortality. One study showed an ability of the CGA to influence treatment decision making, whereas six papers suggested a non-significant association between the screening tool/CGA and treatment tolerance.
The studies suggest the feasibility of using a screening tool to select patients for CGA. 'Vulnerability' showed a non-statistically significant association with treatment tolerance, but a significant association with mortality.
综合老年评估（CGA）是一种多学科的诊断过程，评估医学、心理、社会和功能能力。目前尚未对 CGA 在放射肿瘤学中的应用进行系统评价。本文回顾了 CGA 在放射肿瘤学中的应用，检查了此类评估是否可行，并评估了这些评估在预测和改变结局方面的有效性。
我们检索了 Medline、EMBASE、PsycINFO、CINAHL 和 Cochrane Library 中 1996 年 1 月 1 日至 2017 年 1 月 24 日发表的文章。
确定了 12 项非随机研究；其中 4 项研究仅使用老年筛查工具，另外 8 项研究将筛查工具与 CGA 相结合。大多数研究的样本量较小（平均 63 名参与者）。两项研究发现异常筛查与死亡率增加之间存在显著（95%置信区间 1.5-4.8 和 1.5-6.9）关联。一项研究表明 CGA 能够影响治疗决策，而六篇论文表明筛查工具/CGA 与治疗耐受性之间无显著关联。
这些研究表明使用筛查工具选择接受 CGA 的患者是可行的。“脆弱性”与治疗耐受性无统计学显著关联，但与死亡率有显著关联。
