Management of Frail and Not-Frail elderly cancer patients in a hospital-based geriatric oncology program

Basso, Umberto; Tonti, S.; Bassi, Catia; Brunello, Antonella; Pasetto, Lara Maria; Scaglione, Daniela; Falci, Cristina; Beda, M.; Aversa, Savina; Stefani, Micaela; Castegnaro, E; Tamellini, Fabio; Monfardini, S.

doi:10.1016/j.critrevonc.2007.12.006

Cited by 59 publications

(64 citation statements)

References 29 publications

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“…More than half of the patients had a disability on the IADL scale and more than one-third on the ADL scale, values similar to those reported elsewhere. 22 No difference was found between patients evaluated before versus during cancer therapy, although one might expect to find more dependency among the former patients. One study of patients in a senior adult oncology program showed only a weak correlation between comorbidity and functional status.…”

Section: Discussionmentioning

confidence: 94%

Factors leading oncologists to refer elderly cancer patients for geriatric assessment

Lazarovici

Khodabakhshi

Leignel

et al. 2011

Journal of Geriatric Oncology

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Section: Discussionmentioning

confidence: 94%

Factors leading oncologists to refer elderly cancer patients for geriatric assessment

Lazarovici

Khodabakhshi

Leignel

et al. 2011

Journal of Geriatric Oncology

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“…Although there were no differences in the use of the "elderlyfriendly" treatment among the frail and nonfrail (40% of frail patients and 39% of nonfrail patients), in the dose reduction greater than or equal to 25% (37.5% vs. 31.2%), in 3-to 4-grade toxicity (52.5% vs. 58.4%), there were remarkable differences between the groups in the percentages of premature interruption of treatment because of toxicity or the patient's refusal (42.5% vs. 15.6%) and the deaths within 30 days of the last dosage of the chemotherapy (22.5% vs. 3.9%). This demonstrates that the frail patients had obtained benefits from the treatment that were notably lesser not only in terms of tumor response (21.2% vs. 44.3% in 94 evaluated patients) but also in terms of clinical benefits (22.6% vs. 45.8% in 90 evaluated patients) 15 .…”

Section: Dear Editormentioning

confidence: 96%

Geriatric Evaluation Programs and Elderly Oncology Patients

Jirillo¹,

Trentin²

2011

International Journal of Gerontology

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“…On the other hand, standard protocols may lead to increased risk of toxicity and overtreatment for some patients. 70 Moreover, cancer stage may sometimes be underestimated if patients' nonspecific symptoms are attributed to comorbid conditions or the ageing process. 10 Optimal functional status represents a critical outcome in older cancer patients.…”

Section: Treatment Outcomesmentioning

confidence: 99%

Integrated oncogeriatric approach: a systematic review of the literature using concept analysis

et al. 2012

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ObjectivesThe purpose of this study was to provide a more precise definition of an integrated oncogeriatric approach (IOGA) through concept analysis.Data sourcesThe literature was reviewed from January 2005 to April 2011 integrating three broad terms: geriatric oncology, multidisciplinarity and integrated care delivery models.Study eligibility criteriaCitation selection was based on: (1) elderly cancer patients as the study population; (2) disease management and (3) case studies, intervention studies, assessments, evaluations and studies. Inclusion and exclusion criteria were refined in the course of the literature search.InterventionsInitiatives in geriatric oncology that relate to oncology services, social support services and primary care services for elderly cancer patients.ParticipantsElderly cancer patients aged 70 years old or more.Study appraisal and synthesis methodsRodgers’ concept analysis method was used for this study. The analysis was carried out according to thematic analysis based on the elements of the Chronic Care Model.ResultsThe search identified 618 citations. After in-depth appraisal of 327 potential citations, 62 articles that met our inclusion criteria were included in the analysis. Three IOGA main attributes were identified, which constitute IOGA's core aspects: geriatric assessment (GA), comorbidity burden and treatment outcomes. The IOGA concept comprises two broad antecedents: coordinated healthcare delivery and primary supportive care services. Regarding the consequents of an integrated approach in geriatric oncology, the studies reviewed remain inconclusive.ConclusionsOur study highlights the pioneering character of the multidimensional IOGA concept, for which the relationship between clinical and organisational attributes, on the one hand, and contextual antecedents, on the other, is not well understood. We have yet to ascertain IOGA's consequents.Implications of key findingsThere is clearly a need for a whole-system approach to change that will provide direction for multilevel (clinical, organisational, strategic) interventions to support interdisciplinary practice, education and research.

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Management of Frail and Not-Frail elderly cancer patients in a hospital-based geriatric oncology program

Cited by 59 publications

References 29 publications

Factors leading oncologists to refer elderly cancer patients for geriatric assessment

Factors leading oncologists to refer elderly cancer patients for geriatric assessment

Geriatric Evaluation Programs and Elderly Oncology Patients

Integrated oncogeriatric approach: a systematic review of the literature using concept analysis

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