Introduction
Despite consensus guidelines on best practice in the care of older patients with cancer, geriatric assessment (GA) has yet to be optimally integrated into the field of oncology in most countries. There is a relative lack of consensus in the published literature as to the best approach to take, and there is a degree of uncertainty as to how integration of geriatric medicine principles might optimally predict patient outcomes.
The aim of the current study was to obtain consensus on GA in oncology to inform the implementation of a geriatric oncology programme.
Methods
A four round Delphi process was employed. The Delphi method is a structured group facilitation process, using multiple iterations in order to gain consensus on a given topic
Results
Consensus was reached on the optimal assessment method and interventions required for the commonly employed domains of GA. Other aspects of GA, such as screening methods and age cutoff for assessment represented a higher degree of disagreement.
Discussion
The expert panel employed in this study clearly identified the criteria that should be included in a clinical geriatric oncology programme. In the absence of evidence-based guidelines, this may prove useful in the care of older cancer patients.
The studies demonstrated significant potential of AS as a useful delineation tool in contouring target volumes and OARs in head and neck cancers. However, it is evident that AS cannot totally replace manual delineation in contouring some structures in the head and neck and cannot be used independently without human intervention. It is also emphasized that delineation studies should be conducted locally so as to evaluate the true value of AS in head and neck cancers in a specific center.
European Society for radiotherapy and oncology (ESTRO) committee The ESTRO Radiation Therapist committee (RTTC) is made up of 14 representatives (including 2 elected members of the RTT alliance) working as radiation therapists (RTTs) in clinical departments and academic institutes. The role of the RTT in Europe has been described in previous ESTRO documents, with clear guidelines and definitions as to the educational standards required of an undergraduate practitioner (level 6) [1] and advanced/specialist practitioner (7&8) [2]. From here on, this paper will refer to our profession as RTT.
While there is a growing body of evidence in support of plan libraries for bladder RT, many studies differed in their delivery approach. The advent of the clinical use of the MRI-linear accelerator will provide RT departments with the opportunity to consider daily online adaption for bladder cancer as an alternate to plan library approaches.
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