Recognizing Frailty in Radiation Oncology Clinical Practice: Current Evidence and Future Directions.

The number of older adults presenting for radiation therapy is increasing, as many older adults may be excluded from receipt of surgery and chemotherapy due to multimorbidity or concerns about toxicity. For radiation oncologists, making decisions about appropriate treatment modalities for their older patients can be difficult. Comprehensive Geriatric Assessment (CGA) is recommended to aid the decision-making process in radiation oncology, in conjunction with the judicious use of frailty screening tools, which are the first step in identifying those who need a CGA. In this review, the current scientific evidence regarding screening tools and CGA will be appraised in the context of radiation oncology. Several screening tools that have been tested in radiation oncology are described, as well as how they have been combined (or not) with CGA. Current clinical practice is reviewed, and future directions for radiation oncology are discussed.