Department of Radiation Oncology, Izmir City Hospital, İzmir, Turkey.
Department of Radiation Oncology, Medstar Antalya Hospital, Antalya, Turkey; Antalya Bilim University, Antalya, Turkey.
Adv Cancer Res. 2024;164:283-309. doi: 10.1016/bs.acr.2024.07.003. Epub 2024 Aug 23.
Older adults with cancer are at risk of over-treatment or under-treatment, and treatment decision-making is difficult due to both the complexity of adverse aging and under-representation in clinical trials. It is recommended to perform a frailty assessment before treatment decision-making. Although the importance of radiotherapy increases in geriatric oncology, there is less evidence base information on frailty assessment in radiation oncology than in medical/surgical oncology. The present literature review analyzed the available data regarding frailty assessment tools in geriatric radiation oncology. The predictive value of geriatric assessment on survival outcomes has been shown in many cancer subtypes treated with radiotherapy. Additionally, the Geriatric-8 score is the most evidenced screening tool in frailty assessment. However, researches are ongoing on the cut-off points of geriatric screening tools and which one is the best. Prospective randomized controlled trials are required for the integration of geriatric screening tools and geriatric assessment-driven interventions into geriatric radiation oncology practice.
老年癌症患者存在过度治疗或治疗不足的风险，且由于衰老的复杂性以及临床试验中代表性不足，治疗决策较为困难。建议在治疗决策前进行虚弱评估。尽管老年肿瘤学中放疗的重要性增加，但在放射肿瘤学中，虚弱评估的证据基础信息比医学/外科肿瘤学中要少。本文献复习分析了老年放射肿瘤学中可用的虚弱评估工具的相关数据。在接受放疗治疗的许多癌症亚型中，老年综合评估对生存结局的预测价值已得到证实。此外，老年-8 评分是虚弱评估中最具证据的筛查工具。然而，目前仍在研究老年筛查工具的截断值以及哪种工具最佳。需要进行前瞻性随机对照试验，以将老年综合评估和老年综合评估驱动的干预措施纳入老年放射肿瘤学实践中。
