Hipólito-Reis Helena, Santos Joana, Almeida Paulo, Teixeira Luciana, Rodrigues Fernando, Tavares Nuno Teixeira, Rodrigues Darlene, Almeida Jorge, Osório Fernando
Department of Internal Medicine, São João University Hospital (ULS São João), 4200-319 Porto, Portugal.
Department of Nutrition, São João University Hospital (ULS São João), 4200-319 Porto, Portugal.
Curr Oncol. 2024 Dec 4;31(12):7809-7819. doi: 10.3390/curroncol31120575.
(1) Background: Breast cancer (BC) has a high incidence in Europe, particularly in older adults. Traditionally under-represented in clinical trials, this age group is often undertreated due to ageism. This study aims to characterize frail older adults (≥70 years) with BC based on a comprehensive geriatric assessment, to guide individualized treatment decision-making. (2) Methods: A descriptive analysis of older adults with BC treated from January 2021 to December 2022 was performed. Data were analyzed based on anonymized electronic medical records. (3) Results: Of 123 patients (mean age 84.0 ± 5.6 years), 122 (99.2%) were women. The mean G8 screening score was 12.1 ± 2.5. Most had functional dependence (69.9% Barthel Index, 81.3% Lawton/Brody Scale) and a moderate-to-high risk of falling (76.4% Tinetti index). Cognitive impairment and malnutrition risk were present in 15.4% and 30.1%, respectively. Prehabilitation inclusive strategies led to adapted treatment in 55.3% of cases. Endocrine therapy, surgery, radiotherapy, and chemotherapy was used in 99.2%, 56.1%, 35.0%, and 8.9% of patients, respectively. (4) Conclusions: Our comprehensive oncogeriatric strategy promotes personalized oncologic treatment, improves outcomes by addressing frailty, and enhances treatment tolerability in older patients with BC, validating the expansion of this combined team approach to other cancer types and institutions.
(1) 背景：乳腺癌（BC）在欧洲发病率很高，尤其是在老年人中。这个年龄组在临床试验中的代表性传统上不足，由于年龄歧视，该年龄组的治疗往往不足。本研究旨在基于全面的老年医学评估对患有乳腺癌的体弱老年人（≥70岁）进行特征描述，以指导个体化治疗决策。(2) 方法：对2021年1月至2022年12月接受治疗的老年乳腺癌患者进行描述性分析。基于匿名电子病历分析数据。(3) 结果：在123例患者（平均年龄84.0±5.6岁）中，122例（99.2%）为女性。G8筛查平均得分为12.1±2.5。大多数患者有功能依赖（Barthel指数为69.9%，Lawton/Brody量表为81.3%）以及中到高跌倒风险（Tinetti指数为76.4%）。认知障碍和营养不良风险分别占15.4%和30.1%。术前综合干预策略使55.3%的病例得到了适应性治疗。分别有99.2%、56.1%、35.0%和8.9%的患者接受了内分泌治疗、手术、放疗和化疗。(4) 结论：我们的综合肿瘤老年医学策略促进了个性化肿瘤治疗，通过解决体弱问题改善了治疗结果，并提高了老年乳腺癌患者的治疗耐受性，验证了这种联合团队方法在其他癌症类型和机构中的推广应用。
