Department of Oncogeriatrics, Center of Geriatric Medicine, St. Marien-Hospital, Cologne, Germany.
Clin Interv Aging. 2023 Mar 28;18:505-521. doi: 10.2147/CIA.S365494. eCollection 2023.
Frailty, an age-related condition of increased vulnerability to acute endogenous or exogenous stressors, is a key barrier to successful treatment of cancer in older people. In this group of patients, assessment of frailty is required before starting a new treatment. According to guidelines, the gold standard to assess frailty in older adults with cancer is geriatric screening followed by geriatric assessment (GA) across essential GA-domains (social status, physical function, nutrition, cognition, emotion, co-morbidity, polypharmacy). GA enables tailoring of both oncological therapy and non-oncological interventions to the patient's vulnerabilities. Large clinical trials recently have demonstrated that the feasibility and tolerability of systemic cancer treatment in older patients are significantly improved by such GA-guided management. Indications and optimal tools for frailty monitoring during the course of cancer treatment have not yet been defined in greater detail. New technologies such as wearable sensors or apps offer promising new opportunities to further develop frailty monitoring. This review describes the current standards and perspectives for the assessment and monitoring of frailty in elderly patients with cancer.
衰弱是一种与年龄相关的易感性增加的状态,易受急性内源性或外源性应激源的影响,是老年人成功治疗癌症的关键障碍。在这组患者中,在开始新的治疗之前需要评估衰弱情况。根据指南,评估老年癌症患者衰弱的金标准是老年筛查,然后是跨基本老年评估领域(社会地位、身体功能、营养、认知、情感、合并症、多药治疗)的老年评估。老年评估使肿瘤治疗和非肿瘤干预措施能够根据患者的脆弱性进行调整。最近的大型临床试验表明,通过这种老年评估指导管理,可以显著提高老年患者接受全身癌症治疗的可行性和耐受性。在癌症治疗过程中监测衰弱的指征和最佳工具尚未更详细地确定。可穿戴传感器或应用程序等新技术为进一步开发衰弱监测提供了有前途的新机会。这篇综述描述了评估和监测老年癌症患者衰弱的当前标准和观点。