Brigham and Women's Hospital, Marcus Institute for Aging Research, Harvard Medical School, Boston, MA, United States of America.
City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America.
J Geriatr Oncol. 2020 Mar;11(2):203-211. doi: 10.1016/j.jgo.2019.08.005. Epub 2019 Aug 23.
Until recently, the progress in the diagnosis and management of cancer has not been matched by similar progress in the assessment of the increasing numbers of older and more complex patients with cancer. Dr. Arti Hurria identified this gap at the outset of her career, which she dedicated toward studying the geriatric assessment (GA) as an improvement over traditional methods used in oncology to assess vulnerability in older patients with cancer. This review documents the progress of the GA and its integration into oncology. First, we detail the GA's origins in the field of geriatrics. Next, we chronicle the early rise of geriatric oncology, highlighting the calls of early thought-leaders to meet the demands of the rapidly aging cancer population. We describe Dr. Hurria's early efforts toward meeting these calls though the implementation of the GA in oncology research. We then summarize some of the seminal studies constituting the evidence base supporting GA's implementation. Finally, we lay out the evolution of cancer-focused guidelines recommending the GA, concluding with future needs to advance the next steps toward more widespread implementation in routine cancer care. Throughout, we describe Dr. Hurria's vision and its execution in driving progress of the GA in oncology, from her fellowship training to her co-authored guidelines recommending GA for all older adults with cancer-published in the year of her untimely death.
直到最近,癌症的诊断和治疗方面的进展并没有跟上评估越来越多的老年和更复杂的癌症患者的类似进展。Arti Hurria 博士在她职业生涯的早期就发现了这一差距,她致力于研究老年评估(GA),作为一种改进,而不是传统的用于评估癌症老年患者脆弱性的方法。这篇综述记录了 GA 的进展及其在肿瘤学中的整合。首先,我们详细介绍了 GA 在老年医学领域的起源。接下来,我们按时间顺序记录了老年肿瘤学的早期兴起,强调了早期思想领袖呼吁满足快速老龄化的癌症人群的需求。我们描述了 Hurria 博士通过在肿瘤学研究中实施 GA 来满足这些呼吁的早期努力。然后,我们总结了一些构成支持 GA 实施的证据基础的重要研究。最后,我们概述了推荐 GA 的以癌症为重点的指南的演变,最后提出了在常规癌症护理中更广泛实施的下一步的未来需求。在整个过程中,我们描述了 Hurria 博士在推动 GA 在肿瘤学中的进展方面的远见卓识及其执行力,从她的研究员培训到她合著的指南,建议对所有患有癌症的老年成年人进行 GA——该指南发表于她英年早逝的那一年。