Comprehensive Geriatric Assessment in Men Aged 70 Years or Older with Localised Prostate Cancer Undergoing Radical Radiotherapy

Osborne, G.E.C.; Appleyard, S.; Gilbert, Duncan C.; Jones, Christopher I.; Lorimer, C.; Villanueva, M.J.; Peasgood, E.; Robinson, Angus; Nikapota, Ashok; Ring, Alistair

doi:10.1016/j.clon.2017.05.003

Cited by 27 publications

(36 citation statements)

References 34 publications

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“…Secondly, the number of patients in our study who experienced decreased QoL was limited. One study that reported higher levels of comorbidity did find that comorbidity was predictive of impaired long-term QoL after prostate cancer radiotherapy associated with ADT [11]; another, like this study, found no CGA parameter that was predictive for significant radiotherapy toxicity [10]. It is possible that the G8 and CGA tools are poorly-adapted to radiotherapy and localized cancer [12], having been principally developed for chemotherapy or major surgery [13,14].…”

Section: Discussionmentioning

confidence: 56%

“…Similarly, geriatricians usually give importance to the risk of falls as a mark of fragility [13] but fewer than 10% of our patients were found to be at high risk of falling. This suggested that screening tools such as the G8 seem ill-suited to detecting vulnerabilities in this particular population, but even with the fuller CGA used in our study, we failed to predict tolerance of radiotherapy [10]. The development and evaluation of new tools are needed.…”

Section: Discussionmentioning

confidence: 80%

“…Geriatric screening tools have been developed to orient frail patients before any oncologic intervention [6], but comprehensive geriatric assessment (CGA) provides a more accurate evaluation. Although CGA is common prior to surgery, chemotherapy [7], or ADT [8], specific studies on prostate cancer radiotherapy in elderly patients have mostly been retrospective, lacking in accurate geriatric evaluation [9], or have focused on toxicity (physician-reported) rather than quality of life (self-reported) [10]. Our study was designed to address this gap and determine whether using CGA is capable of predicting QoL outcomes following radiotherapy for localized prostate cancer in the elderly.…”

Section: Introductionmentioning

confidence: 99%

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Can Comprehensive Geriatric Assessment Predict Tolerance of Radiotherapy for Localized Prostate Cancer in Men Aged 75 Years or Older?

Goineau

Campion

Commer

et al. 2020

Cancers

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Curative radiotherapy for prostate cancer is common in the elderly. However, concerns about potential toxicity have inhibited access to radiotherapy for this population, for whom preserving quality of life (QoL) is crucial. The primary endpoint was to identify predictors of impaired QoL in men aged 75 years or older treated with curative intent radiotherapy with or without androgen deprivation therapy (ADT) for localized prostate cancer. We prospectively performed comprehensive geriatric assessment (CGA) and administered QoL questionnaires to 208 elderly (>75 years) patients prior to, plus two and six months after, radiotherapy (NCT 02876237). The median age of the patients was 77 years (range 75–89). At the start of the study, comorbidities were highlighted in 65% of patients: 23% were depressed, 23% had cognitive impairment, and 16% had reduced independence. At six months, 9% of patients had a consistently decreased QoL (>20 points), and a further 16% had a more moderate reduction (10 to 20 points) in QoL. None of the parameters studied (tumor characteristic, treatment, or oncogeriatric parameters) were predictive of a reduced QoL following radiotherapy. Though co-existing geriatric impairment was common, QoL was maintained for 75% of patients six months after radiotherapy. CGA was poorly predictive of tolerance of prostatic radiotherapy. Geriatric assessments dedicated to quality of life following radiotherapy need to be developed.

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Can Comprehensive Geriatric Assessment Predict Tolerance of Radiotherapy for Localized Prostate Cancer in Men Aged 75 Years or Older?

Goineau

Campion

Commer

et al. 2020

Cancers

View full text Add to dashboard Cite

show abstract

“…Comprehensive Geriatric assessment (CGA) enables precise scoring of daily activities, risk of fall, undernutrition, depression, and comorbidities to help predict whether aggressive cancer treatments will be tolerated. Although CGA is largely used prior to medical interventions, such as chemotherapy [ 14 ] or ADT [ 15 – 17 ], specific studies of older prostate cancer patients undergoing radiotherapy are mostly retrospective, lack precise oncogeriatric evaluation [ 18 – 21 ] or focused on toxicity (assessed by physicians) and not on patient’s related quality of life [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Comprehensive Geriatric Assessment and quality of life after localized prostate cancer radiotherapy in elderly patients

et al. 2018

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IntroductionRadiotherapy can diminish quality of life (QoL) for prostate cancer patients. Our objective was to evaluate the effect of radiotherapy on QoL in men aged 75 years or older treated with radiotherapy for a localized prostate cancer, and to identify predictors of reduced QoL.Patients and methodsWe prospectively administered a battery of geriatric (MNA, GDS, Get up and Go Test, CIRS-G, ADL, IADL, MMSE), toxicity (IPSS; IIEF 5), and QoL (QLQ C30) screening tests in 100 elderly patients before and two months after prostate cancer radiotherapy (NCT 02876237). Patients ≥ 75 years undergoing radiotherapy with a curative intent for localized prostate cancer with or without androgen deprivation therapy (ADL) were eligible for study inclusion. Correlations between patient-assessed QoL and tumor characteristics, radiotherapy treatment or CGA parameters were sought using the Fisher or the Mann and Whitney tests. Changes in QoL parameters over time were analyzed using the Wilcoxon signed-rank test.ResultsAt study entry, scores for IADL impairments were present in 51%, reduced autonomy in activities of daily living in 16%, cognitive impairment found in 20%, depression-related symptoms in 31%, and 66% of patients had significant co-morbidities. Eight percent were judged to be at risk of fall and 2% were found to be undernourished. Severely impaired (IPSS ≥ 20) urinary function was observed in 11.2% and 13.5% of patients before and two months after completion of radiotherapy respectively. Significantly decreased QoL (> 20 points) at two months after treatment was found in 13% of patients and a moderate but clinically relevant reduction (10 to 20 points) in 17% of patients. No tumor characteristic, treatment, or oncogeriatric parameter was predictive of reduced QoL following prostate cancer radiotherapy.ConclusionDespite sometimes markedly diminished oncogeriatric parameters, prostate cancer radiotherapy was generally well tolerated in these elderly patients. We found no predictive factor to determine which patients would experience impaired quality of life following radiotherapy.

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“…Für andere Fragestellungen beim Prostatakarzinom wie z. B. der Vorhersage von Komplikationen der Strahlentherapie bei älteren Patienten hat sich der G8-Fragebogen bisher nicht als signifikanter prognostischer Faktor erwiesen [14].…”

Section: Diskussionunclassified

Der G8-Fragebogen als geriatrisches Screening-Tool in der Uroonkologie

et al. 2019

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ZusammenfassungDer G8-Fragebogen ist ein von der SIOG und EAU empfohlenes geriatrisches Screening-Tool, das zum Zeit- und Ressourcenschonen einem kompletten geriatrischen Assessment („comprehensive geriatric assessment“, CGA) vorgeschaltet werden kann. Die Anwendung des Fragebogens hat sich in unserem klinischen Alltag bewährt, da die 8 Items schnell und problemlos in 4 – 5 Minuten im Stil einer Checkliste auch von nicht geriatrisch geschultem Personal bearbeitet werden können. Mittlerweile ist der G8-Fragebogen in der geriatrischen Onkologie ein etabliertes Screening-Tool. Mehrfach wurde in Studien bewiesen, dass er einen unabhängigen Vorhersagewert in Bezug auf das Gesamtüberleben von Patienten hat. Kritische Aspekte bei der Anwendung bleiben seine relativ geringe Testspezifität (60 %), sein Fokus auf Ernährungsaspekte und mögliche Interobserverdifferenzen. Diese Aspekte sollten vom Anwender gekannt und beachtet werden.

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Comprehensive Geriatric Assessment in Men Aged 70 Years or Older with Localised Prostate Cancer Undergoing Radical Radiotherapy

Abstract: Many older men with localised prostate cancer are vulnerable according to a CGA. The screening tools evaluated were not sufficiently sensitive to identify this group. CGA outcome does not predict for significant acute radiotherapy toxicity.

Cited by 27 publications

References 34 publications

Can Comprehensive Geriatric Assessment Predict Tolerance of Radiotherapy for Localized Prostate Cancer in Men Aged 75 Years or Older?

Can Comprehensive Geriatric Assessment Predict Tolerance of Radiotherapy for Localized Prostate Cancer in Men Aged 75 Years or Older?

Comprehensive Geriatric Assessment and quality of life after localized prostate cancer radiotherapy in elderly patients

Der G8-Fragebogen als geriatrisches Screening-Tool in der Uroonkologie

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