Concord Cancer Centre, Concord Repatriation General Hospital, Sydney, Australia; University of Sydney, Sydney, Australia.
Concord Cancer Centre, Concord Repatriation General Hospital, Sydney, Australia; University of Sydney, Sydney, Australia.
J Geriatr Oncol. 2019 Mar;10(2):210-215. doi: 10.1016/j.jgo.2018.11.004. Epub 2018 Nov 28.
BACKGROUND: The use of geriatric assessment (GA) and the Cancer and Aging Research Group (CARG) Toxicity Score by Australian oncologists is low. We sought oncologists' views about the value of GA and the CARG Score when making decisions about chemotherapy for their older patients. METHODS: Patients aged ≥65 yrs. with a plan to start chemotherapy for a solid organ cancer underwent a GA and had their CARG Score calculated. Results of the GA and CARG Score were provided to treating oncologists who then completed a questionnaire on the value of these measures for each patient. RESULTS: We enrolled 30 patients from eight oncologists. Patients had a median age of 76 years and most (77%) were ECOG performance status 0 or 1. Risk category for severe chemotherapy toxicity by CARG Score was low in 7 patients (23%), intermediate in 18 (60%), and high in 5 (17%). The GA provided oncologists new information for 12 patients (40%), most frequently in the domains of function and nutrition. Knowledge of the GA prompted supportive interventions for 7 patients (23%). Oncologists considered modifications to recommended chemotherapy based on the CARG Score for 2 patients (7%) (one more intensive and one less intensive), and based on GA for no patients. Oncologists judged the GA and CARG Score as useful in 26 (87%) and 25 (83%) patients, respectively. CONCLUSION: Although oncologists valued the GA and CARG Score, they rarely used them to modify chemotherapy. The GA provided new information that prompted supportive interventions in one quarter of patients.
背景：澳大利亚肿瘤学家对老年综合评估（GA）和癌症与衰老研究组（CARG）毒性评分的使用较低。我们想了解肿瘤学家在为老年患者制定化疗决策时对 GA 和 CARG 评分的价值的看法。
方法：年龄≥65 岁且计划开始接受实体瘤癌症化疗的患者接受 GA，并计算其 CARG 评分。GA 和 CARG 评分的结果提供给治疗肿瘤学家，然后他们为每位患者完成一份关于这些措施价值的问卷。
结果：我们从 8 位肿瘤学家中纳入了 30 名患者。患者的中位年龄为 76 岁，大多数（77%）为 ECOG 体能状态 0 或 1。根据 CARG 评分，7 名患者（23%）的严重化疗毒性风险类别低，18 名患者（60%）为中危，5 名患者（17%）为高危。GA 为 12 名患者（40%）提供了新的信息，主要是在功能和营养方面。GA 知识促使对 7 名患者（23%）进行了支持性干预。根据 CARG 评分，有 2 名患者（7%）（1 名更密集，1 名不密集）考虑修改推荐的化疗方案，而根据 GA 评分，没有患者修改。26 名患者（87%）和 25 名患者（83%）分别认为 GA 和 CARG 评分有用。
结论：尽管肿瘤学家重视 GA 和 CARG 评分，但他们很少使用它们来修改化疗方案。GA 为四分之一的患者提供了新的信息，从而促使进行了支持性干预。
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