Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
Eastern Health Clinical School, Monash University.
Curr Opin Support Palliat Care. 2021 Mar 1;15(1):16-22. doi: 10.1097/SPC.0000000000000533.
This review highlights the latest development in the use of geriatric assessment(GA) and frailty assessment for older adults with cancer.
From 2019, there were six large randomized controlled trials (RCTs) completed of GA for older adults with cancer, as well as several studies of frailty screening tools.
The findings in this review highlight the benefits of implementing GA, followed by interventions to address the identified issues (GA -guided interventions). Four of six RCTs that implemented GA for older adults with cancer showed positive impact on various outcomes, including treatment toxicity and quality of life. GA implementation varied significantly between studies, from oncologist acting on GA summary, geriatrician comanagement, to full GA by a multidisciplinary team. However, there were several barriers reported to implementing GA for all older adults with cancer, such as access to geriatrics and resource issues. Future research needs to elucidate how to best operationalize GA in various cancer settings. The authors also reviewed frailty screening tools and latest evidence on their use and impact.
本文重点介绍了老年癌症患者应用老年综合评估（GA）和衰弱评估的最新进展。
自 2019 年以来，已有 6 项关于老年癌症患者 GA 的大型随机对照试验（RCT）完成，以及一些关于衰弱筛查工具的研究。
本综述的结果强调了实施 GA 以及针对所确定问题进行干预的重要性（GA 指导干预）。在 6 项对老年癌症患者实施 GA 的 RCT 中，有 4 项研究显示对各种结局有积极影响，包括治疗毒性和生活质量。在这些研究中，GA 的实施差异很大，从肿瘤医生根据 GA 总结采取行动、老年医学医生共同管理到多学科团队进行全面 GA。然而，据报道，在所有老年癌症患者中实施 GA 存在一些障碍，例如获得老年医学和资源问题。未来的研究需要阐明如何在各种癌症环境中最好地实施 GA。作者还回顾了衰弱筛查工具以及最近关于其使用和影响的证据。
