Department of Radiation Oncology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310000, Zhejiang, People's Republic of China.
Department of Radiation Oncology, Hangzhou Cancer Hospital, Hangzhou 310000, Zhejiang, People's Republic of China,
Clin Interv Aging. 2018 Nov 8;13:2275-2287. doi: 10.2147/CIA.S179014. eCollection 2018.
The aim of this study was to review the published literature addressing the question of whether geriatric assessment (GA) should be routinely applied in the treatment of older adults with esophageal cancer (EC) who have received definitive concurrent chemoradiotherapy (dCRT).
A literature search of PubMed, Embase, and Cochrane Library was performed. Studies that contained original data outlining the inclusion and exclusion criteria, treatment compliance rate, and severe toxicity reports were reviewed. Additionally, criteria from ongoing clinical trials in the World Health Organization and National Institutes of Health registries were reviewed to evaluate the utilization of GA-related domains in elderly EC patients who received dCRT.
Twenty-nine studies were identified based on the selection criteria: five were single-arm prospective studies, and the other studies were retrospective studies. All studies used chronological age and performance status as basic descriptors for this subpopulation. The comorbidity index and the malnutrition level were mentioned in several studies. However, factors such as "Demographic data and social support," "Psychology," "Polypharmacy," and "Geriatric syndromes" were not described in any of the included studies. Unfortunately, the results were similar for the registered clinical trials. Finally, treatment compliance and toxicity profile were found to be acceptable in selected elderly EC patients.
The current experience for older adults with EC receiving dCRT is mainly based on the results of a series of retrospective studies. Ongoing clinical trials should routinely consider GA-related domains to select appropriate treatments for patients in the future.
本研究旨在回顾已发表的文献，探讨在接受根治性同步放化疗（dCRT）的老年食管癌（EC）患者中，是否应常规应用老年综合评估（GA）。
对 PubMed、Embase 和 Cochrane Library 进行文献检索。对纳入和排除标准、治疗依从率和严重毒性报告的原始数据进行了综述。此外，还对世界卫生组织和美国国立卫生研究院注册处正在进行的临床试验的标准进行了评估，以评估在接受 dCRT 的老年 EC 患者中，GA 相关领域的应用情况。
根据选择标准确定了 29 项研究：其中 5 项为单臂前瞻性研究，其余为回顾性研究。所有研究均使用年龄和体能状态作为该亚组的基本描述符。几项研究中提到了合并症指数和营养不良水平。然而，纳入的研究均未描述“人口统计学数据和社会支持”、“心理”、“多药治疗”和“老年综合征”等因素。不幸的是，注册临床试验的结果也相似。最后，在选定的老年 EC 患者中，治疗依从性和毒性特征被认为是可接受的。
目前，接受 dCRT 的老年 EC 患者的经验主要基于一系列回顾性研究的结果。未来的临床试验应常规考虑 GA 相关领域，为患者选择合适的治疗方案。
