Wedding Ulrich
Abteilung für Palliativmedizin, Universitätsklinikum Jena, Jena, Deutschland.
Z Gerontol Geriatr. 2019 Feb;52(1):75-86. doi: 10.1007/s00391-018-01499-8.
Demographic changes have resulted in an increasing number of old people. Together with the age-dependent increase cancer incidence rates, the number of older people with cancer will increase significantly in the coming decades. In geriatric medicine, a structured systematic assessment has been established to recognize an individual patient's deficits and resources in order to be able to tailor an individualized treatment plan. Research in geriatric oncology has demonstrated that transfer of the geriatric assessment from geriatric medicine to oncology helps to identify patients with age-dependent deficits, independent of their chronological age. Such impairments are also predictive for a higher risk of treatment-associated side effects and poorer survival. In addition, geriatric assessment helps to stratify older cancer patients for treatment and avoid under- and over-treatment. Current research strategies address the question of whether interventions based on the results of the geriatric assessment can improve outcomes relevant to the patients. In the past, patient-relevant outcomes, such as maintenance of the ability to care for oneself, were poorly integrated in oncological trials.
人口结构的变化导致老年人数量不断增加。随着癌症发病率随年龄增长而上升，未来几十年老年癌症患者的数量将大幅增加。在老年医学中，已建立了结构化的系统评估，以识别个体患者的缺陷和资源，从而能够制定个性化的治疗方案。老年肿瘤学研究表明，将老年评估从老年医学转移到肿瘤学有助于识别存在年龄相关缺陷的患者，而不受其实际年龄的影响。这些损伤也预示着治疗相关副作用的风险更高和生存率更低。此外，老年评估有助于对老年癌症患者进行治疗分层，避免治疗不足和过度治疗。目前的研究策略关注基于老年评估结果的干预措施是否能改善与患者相关的结局这一问题。过去，与患者相关的结局，如自我护理能力的维持，在肿瘤学试验中整合得很差。
