Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA.
Department of Palliative Care, The University of Texas MD Anderson Cancer Center, Houston, USA.
Support Care Cancer. 2019 Nov;27(11):4165-4170. doi: 10.1007/s00520-019-04702-7. Epub 2019 Feb 23.
The oldest old, described as those aged 85 and older, is a growing cancer population. There are limited studies evaluating the symptoms of the oldest old cancer patient population. Our study aimed to evaluate symptom frequency and clinical symptom change as assessed by the Edmonton Symptom Assessment System (ESAS) of the oldest old (≥ 85) compared to older adult (65-84) and general adult (18-64) outpatient cancer patients on initial consult and follow-up visit.
Retrospective review of a total of 441 patients, 200 randomly sampled patients in the general and older adult group and 41 consecutive patients in the oldest old group. Chart review was performed for demographic and clinical information including ESAS.
The oldest old group had less advanced tumors and worse performance status and was receiving less cancer therapy. Eighty percent or more of these patients reported fatigue, sleep disturbance, appetite, and drowsiness. They experienced lower frequencies of pain (p < 0.0001), fatigue (p = 0.0338), nausea (p = 0.0151), feeling of well-being (p = 0.0245), sleep disturbance (p = 0.0484), financial distress (p = 0.0002), and spiritual distress (p = 0.0010) compared to the younger groups. Twenty-six to fifty-one percent of the oldest old patients' symptoms improved on the first follow-up visit.
Oldest old cancer patients have high frequencies of multiple symptoms on initial referral. However, these symptom frequencies are lower when compared to younger age groups. Additionally, many of their symptoms improved on first follow-up visit in the palliative care clinic. More research is needed to address the needs of this growing cancer population and focus symptoms that can improve with palliative care intervention.
最年长的老年人（年龄在 85 岁及以上）是一个不断增长的癌症人群。目前，评估最年长老年癌症患者人群症状的研究有限。我们的研究旨在评估最年长老年人（≥85 岁）与老年（65-84 岁）和一般成年人（18-64 岁）门诊癌症患者在初次就诊和随访时，通过埃德蒙顿症状评估系统（ESAS）评估的症状频率和临床症状变化。
对总共 441 名患者进行回顾性分析，其中 200 名随机抽取的一般和老年组患者和 41 名连续的最年长老年组患者。对包括 ESAS 在内的人口统计学和临床信息进行图表审查。
最年长老年组的肿瘤分期较低，功能状态较差，接受的癌症治疗较少。80%或更多的患者报告疲劳、睡眠障碍、食欲和嗜睡。他们经历的疼痛频率较低（p<0.0001）、疲劳（p=0.0338）、恶心（p=0.0151）、幸福感（p=0.0245）、睡眠障碍（p=0.0484）、经济困难（p=0.0002）和精神困扰（p=0.0010），与年轻组相比。在第一次随访时，最年长老年患者中有 26%至 51%的症状得到改善。
最年长老年癌症患者在初次就诊时就有多种症状的高频率。然而，与年轻组相比，这些症状的频率较低。此外，他们的许多症状在姑息治疗诊所的第一次随访时得到改善。需要更多的研究来满足这个不断增长的癌症人群的需求，并关注可以通过姑息治疗干预改善的症状。
