The effect of comprehensive geriatric assessment on care received, treatment completion, toxicity, cancer-related and geriatric assessment outcomes, and quality of life for older adults receiving systemic anti-cancer treatment: A systematic review

Disalvo, Domenica; Moth, Erin; Soo, Wee Kheng; Garcia, Maja; Blinman, Prunella; Steer, Christopher; Amgarth-Duff, Ingrid; Power, Jack; Phillips, Jane; Agar, Meera

doi:10.1016/j.jgo.2023.101585

Cited by 6 publications

(2 citation statements)

References 44 publications

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“…Second, it was not possible to retrospectively assess treatment-related functional adverse events regarding their potential impact on patients' quality of life. Third, a major problem in retrospective assessment of the general health condition is the high variability between different observers [ 37 ]; consequently, structured geriatric assessments that encompass many different domains of older patients' lives, such as functional, nutritional, cognitive, psychosocial, and socioeconomic status, could provide a more reliable assessment of patients' performance [ 38 ]. For other tumor entities, it has already been shown that geriatric assessment can predict treatment tolerability [ 39 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

Multicenter analysis on the value of standard (chemo)radiotherapy in elderly patients with locally advanced adenocarcinoma of the esophagus or gastroesophageal junction

Bostel,

Nikolaidou,

Wollschläger

et al. 2024

Radiat Oncol

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Background To assess the tolerability and oncological results of chemoradiation in elderly patients with locally advanced adenocarcinoma of the esophagus or gastroesophageal junction. Methods This multi-center retrospective analysis included 86 elderly patients (≥ 65 years) with esophageal or gastroesophageal junction adenocarcinoma (median age 73 years; range 65–92 years) treated with definitive or neoadjuvant (chemo)radiotherapy. The treatment was performed at 3 large comprehensive cancer centers in Germany from 2006 to 2020. Locoregional control (LRC), progression-free survival (PFS), distant metastasis-free survival (DMFS), overall survival (OS), and treatment-associated toxicities according to CTCAE criteria v5.0 were analyzed, and parameters potentially relevant to patient outcomes were evaluated. Results Thirty-three patients (38%) were treated with neoadjuvant chemoradiation followed by surgery, while the remaining patients received definitive (chemo)radiation. The delivery of radiotherapy without dose reduction was possible in 80 patients (93%). In 66 patients (77%), concomitant chemotherapy was initially prescribed; however, during the course of therapy, 48% of patients (n = 32) required chemotherapy de-escalation due to treatment-related toxicities and comorbidities. Twenty-nine patients (34%) experienced higher-grade acute toxicities and 14 patients (16%) higher-grade late toxicities. The 2-year LRC, DMFS, PFS, and OS amounted to 72%, 49%, 46%, and 52%, respectively. In multivariate analysis, neoadjuvant chemoradiation followed by surgery was shown to be associated with significantly better PFS (p = 0.006), DMFS (p = 0.006), and OS (p = 0.004) compared with all non-surgical treatments (pooled definitive radiotherapy and chemoradiation). No such advantage was seen over definitive chemoradiation. The majority of patients with neoadjuvant therapy received standard chemoradiotherapy without dose reduction (n = 24/33, 73%). In contrast, concurrent chemotherapy was only possible in 62% of patients undergoing definitive radiotherapy (n = 33/53), and most of these patients required dose-reduction or modification of chemotherapy (n = 23/33, 70%). Conclusions In our analysis, omission of chemotherapy or adjustment of chemotherapy dose during definitive radiotherapy was necessary for the overwhelming majority of elderly esophageal cancer patients not eligible for surgery, and hence resulted in reduced PFS and OS. Therefore, optimization of non-surgical approaches and the identification of potential predictive factors for safe administration of concurrent chemotherapy in elderly patients with (gastro)esophageal adenocarcinoma is required.

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Section: Discussionmentioning

confidence: 99%

Multicenter analysis on the value of standard (chemo)radiotherapy in elderly patients with locally advanced adenocarcinoma of the esophagus or gastroesophageal junction

Bostel,

Nikolaidou,

Wollschläger

et al. 2024

Radiat Oncol

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“…Psychological interventions, spanning individual counselling to mindfulness-based techniques and group therapies, stood as integral components within comprehensive care strategies [60]. Integrating these interventions into multidisciplinary care was observed to foster resilience, empower patients, and enrich survivorship experiences among elderly individuals navigating cancer [61,62]. In essence, this review advocates for a paradigm shift towards personalized interventions that honour individual experiences and psychological needs within geriatric oncology.…”

Section: Discussionmentioning

confidence: 99%

Unveiling Psychological Perspectives on Aging Minds and Cancer: A Review

Sheelam

2023

ijcsrr

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In geriatric oncology, the intersection of aging complexities and cancer care intricacies shapes the journey of elderly individuals facing cancer. This review explores emotional, cognitive, and social dynamics influencing their experiences and care. Following a cancer diagnosis, older adults navigate a spectrum of emotions—from shock to resilience—crucial in shaping coping strategies and treatment decisions. The toll of cancer treatments, compounded by age-related vulnerabilities, underscores the need for tailored care plans that account for social and familial dynamics. Cognitive functions undergo shifts influenced by aging and treatments, emphasizing the importance of understanding these changes in decision-making processes. Caregiver-patient relationships emerge as pivotal, impacting cognitive well-being and necessitating interventions supporting both parties. Psychological interventions, from counselling to mindfulness practices, offer avenues for comprehensive care. Integrating these interventions into multidisciplinary care fosters resilience and enriches survivorship experiences among elderly cancer patients. This review advocates a personalized approach in geriatric oncology, emphasizing tailored interventions and comprehensive care strategies that honour individual experiences. Future research directions focus on exploring emotional resilience, cognitive adaptability, and intervention outcomes to enhance care for elderly individuals navigating cancer’s challenges. In conclusion, geriatric oncology demands personalized, multidisciplinary care strategies that integrate psychological support and acknowledge the complexities of aging. This integration marks a transformative shift towards holistic care, paving the way for tailored and effective interventions supporting elderly patients throughout their cancer journey.

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The geriatric Asia-Pacific oncology nursing imperative

Boyle

2023

Asia-Pacific Journal of Oncology Nursing

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The effect of comprehensive geriatric assessment on care received, treatment completion, toxicity, cancer-related and geriatric assessment outcomes, and quality of life for older adults receiving systemic anti-cancer treatment: A systematic review

Cited by 6 publications

References 44 publications

Multicenter analysis on the value of standard (chemo)radiotherapy in elderly patients with locally advanced adenocarcinoma of the esophagus or gastroesophageal junction

Multicenter analysis on the value of standard (chemo)radiotherapy in elderly patients with locally advanced adenocarcinoma of the esophagus or gastroesophageal junction

Unveiling Psychological Perspectives on Aging Minds and Cancer: A Review

The geriatric Asia-Pacific oncology nursing imperative

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