Journal of geriatric oncology最新文献

{"title":"Managing older patients with oral targeted cancer therapies in primary care: A qualitative study","authors":"Murielle Glondu-Lassis , Béatrice Lognos , Michel Amouyal , François Carbonnel , Bernard Clary , Valéry Antoine","doi":"10.1016/j.jgo.2024.101843","DOIUrl":"10.1016/j.jgo.2024.101843","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"15 8","pages":"Article 101843"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141912963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The applicability of the Cancer and Aging Research Group (CARG) chemotherapy toxicity prediction tool","authors":"Neha Pathak , Tomohiro F. Nishijima , Eyyüp Cavdar","doi":"10.1016/j.jgo.2024.102070","DOIUrl":"10.1016/j.jgo.2024.102070","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"15 8","pages":"Article 102070"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Glasgow Prognostic Score with frailty, mortality and adverse health outcomes in older patients with cancer: A prospective cohort study","authors":"Yara van Holstein ,&nbsp;Stella Trompet ,&nbsp;Barbara C. van Munster ,&nbsp;P. Janne E. van den Berkmortel ,&nbsp;Diana van Heemst ,&nbsp;Nienke A. de Glas ,&nbsp;Marije Slingerland ,&nbsp;P. Eline Slagboom ,&nbsp;Cynthia Holterhues ,&nbsp;Geert Labots ,&nbsp;Simon P. Mooijaart ,&nbsp;Johanneke E.A. Portielje ,&nbsp;Frederiek van den Bos","doi":"10.1016/j.jgo.2024.102075","DOIUrl":"10.1016/j.jgo.2024.102075","url":null,"abstract":"<div><h3>Introduction</h3><div>To balance benefits and risks of cancer treatment in older patients, prognostic information is needed. The Glasgow Prognostic Score (GPS), composed of albumin and C-reactive protein (CRP), might provide such information. This study first aims to investigate the association between GPS and frailty, functional decline, and health-related quality of life (HRQoL) decline as indicators of health problems in older patients with cancer. The second aim is to study the predictive value of GPS for mortality, in addition to clinical predictors.</div></div><div><h3>Materials and Methods</h3><div>This prospective cohort study included patients aged ≥70 years with a solid malignant tumor who underwent a geriatric assessment and blood sampling before treatment initiation. GPS was calculated using serum albumin and CRP measured in batch, categorized into normal (0) and abnormal GPS (1–2). Outcomes were all-cause mortality and a composite outcome of decline in daily functioning and/or HRQoL, or mortality at one year follow-up. Daily functioning was assessed by Activities of Daily Living and Instrumental Activities of Daily Living questionnaires and HRQoL by the EQ-5D-3L and EQ-VAS questionnaires.</div></div><div><h3>Results</h3><div>In total, 192 patients with a median age of 77 years (interquartile range 72.3–81.0) were included. Patients with abnormal GPS were more often frail compared to those with normal GPS (79 % vs. 63 %, <em>p</em> = 0.03). Patients with abnormal GPS had higher mortality rates after one year compared to those with normal GPS (48 % vs. 23 %, <em>p</em> &lt; 0.01) in unadjusted analysis. Abnormal GPS was associated with increased mortality risk (hazard ratio 2.8, 95 % CI 1.7–4.8). The area under the receiver operating characteristics curve of age, distant metastasis, tumor site, comorbidity, and malnutrition combined was 0.73 (0.68–0.83) for mortality prediction, and changed to 0.78 (0.73–0.86) with GPS (<em>p</em> = 0.10). The composite outcome occurred in 88 % of patients with abnormal GPS versus 83 % with normal GPS (<em>p</em> = 0.44).</div></div><div><h3>Discussion</h3><div>Abnormal GPS was associated with frailty and mortality. The addition of GPS to clinical predictors showed a numerically superior mortality prediction in this cohort of older patients with cancer, although not statistically significant. While GPS may improve the stratification of future older patients with cancer, larger studies including older patients with similar tumor types are necessary to evaluate its clinical usefulness.</div></div><div><h3>Trial Registration</h3><div>The TENT study is retrospectively registered at the Netherlands Trial Register (NTR), trial number NL8107. Date of registration: 22-10-2019.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"15 8","pages":"Article 102075"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting short-term treatment toxicity in head and neck cancer through a systematic review and meta-analysis","authors":"Marco A. Mascarella ,&nbsp;Varun Vendra ,&nbsp;Khalil Sultanem ,&nbsp;Christina Tsien ,&nbsp;George Shenouda ,&nbsp;Shaum Sridharan ,&nbsp;Nathaniel Bouganim ,&nbsp;Khashayar Esfahani ,&nbsp;Keith Richardson ,&nbsp;Alex Mlynarek ,&nbsp;Michael Hier ,&nbsp;Nader Sadeghi ,&nbsp;Umamaheswar Duvvuri ,&nbsp;Marie-Jeanne Kergoat","doi":"10.1016/j.jgo.2024.102064","DOIUrl":"10.1016/j.jgo.2024.102064","url":null,"abstract":"<div><h3>Introduction</h3><div>Frailty is a recognized condition associated with poorer outcomes in patients with head and neck cancer (HNC). The objective of this study was to ascertain the prognostic significance of various frailty metrics on short-term treatment toxicity in patients with HNC undergoing curative-intent therapy.</div></div><div><h3>Materials and Methods</h3><div>A systematic review was performed searching multiple databases. An inverse-variation, random-effects model was used to perform the meta-analysis to evaluate the prognostic significance of various frailty metrics on short-term treatment-related toxicity in this population.</div></div><div><h3>Results</h3><div>A total of 292,560 patients with HNC originating from 36 observational studies were analyzed. The most frequently reported frailty metrics were the modified frailty index (mFI), Geriatric 8 questionnaire (G8), Adjusted Clinical Groups (ACG), Groningen Frailty Indicator (GFI), and comprehensive geriatric assessment (CGA). The overall prevalence of frailty using any metric in all included studies was 7.5 %. The combined odds ratio (OR) for short-term treatment toxicity using the mFI was 2.60 (95 % CI of 1.81–3.72), G8 2.69 (95 % CI 1.37–5.28), ACG 3.43 (95 %CI 2.52–4.67), GFI 2.71 (95 % CI 1.11–6.62), and CGA 3.36 (95 % CI 1.18–9.53). The association of frailty with short-term treatment toxicity using various frailty metrics was more pronounced in patients with upfront surgery (OR 3.00, 95 %CI of 2.35–3.81) compared to definitive (chemo)radiotherapy 2.64 (95 % CI 1.04–6.68).</div></div><div><h3>Discussion</h3><div>Various frailty metrics exists in the HNC literature, with the most common being the mFI, G8, ACG, GFI, and CGA. Patients with HNC and frailty are more than twice as likely to suffer a short-term treatment-related toxicity when undergoing curative-intent HNC treatment than patients without frailty. This effect is more pronounced in patients undergoing upfront surgery.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"15 8","pages":"Article 102064"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age and postoperative swallowing function in patients treated for advanced oral cancer: A retrospective study","authors":"Seth E. Amos ,&nbsp;Georges E. Daoud ,&nbsp;Shubham R. Patel ,&nbsp;Andre J. Burnham ,&nbsp;Lauren Ottenstein ,&nbsp;H. Michael Baddour ,&nbsp;Andrew Tkaczuk ,&nbsp;Nicole C. Schmitt","doi":"10.1016/j.jgo.2024.101841","DOIUrl":"10.1016/j.jgo.2024.101841","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"15 8","pages":"Article 101841"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in the use of granulocyte colony stimulating factors for older patients with cancer, 2010 to 2019","authors":"Kaylee Fish ,&nbsp;Daoqi Gao ,&nbsp;Mukaila Raji ,&nbsp;Lodovico Balducci ,&nbsp;Yong-Fang Kuo","doi":"10.1016/j.jgo.2024.102049","DOIUrl":"10.1016/j.jgo.2024.102049","url":null,"abstract":"<div><h3>Introduction</h3><div>Older patients with cancer receiving myelosuppressive treatment are at an increased risk for developing febrile neutropenia (FN) or having chemotherapy dose-reductions or delays, resulting in suboptimal health outcomes. Granulocyte colony stimulating factors (G-CSF) are effective medications to reduce these adverse events and are recommended for patients <span><math><mo>≥</mo></math></span>65 years receiving chemotherapy with &gt;10 % FN risk. We sought to characterize the trends and predictors of G-CSF use between the youngest-old (66–74 years), middle-old (75–84 years), and oldest-old (<span><math><mo>≥</mo></math></span>85 years) patients with cancer.</div></div><div><h3>Materials and Methods</h3><div>We used registry data from SEER-Medicare for breast, lung, ovarian, colorectal, esophageal, gastric, uterine, prostate, pancreatic cancer, and non-Hodgkin lymphoma (NHL) diagnoses from 2010 to 2019. Cox proportional hazard analysis was used.</div></div><div><h3>Results</h3><div>Overall, 41.4 % of patients received G-CSF from chemotherapy initiation to three days after completion of the first chemotherapy course. The use rate remained relatively stable for all cancers, except for an increase in use for those with pancreatic cancer. G-CSF use decreased as patients got older. The oldest-old were 43.0 % (95 % confidence interval: 40.7–45.2 %) less likely to receive G-CSF compared to the youngest-old. Patients with breast cancer or NHL were more likely to receive G-CSF than those with other cancers. Patients who were female, married, White or Hispanic, and had fewer comorbidities were more likely to receive G-CSF.</div></div><div><h3>Discussion</h3><div>G-CSF is used less often in populations at higher risk of developing FN and related complications. Improving adherence to recommendations can improve health outcomes, especially in the oldest adults, older males, and Black patients.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"15 8","pages":"Article 102049"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive geriatric assessment as an indicator of postoperative recovery in older patients with colorectal cancer","authors":"Fuminori Teraishi ,&nbsp;Ryohei Shoji ,&nbsp;Yoshitaka Kondo ,&nbsp;Shunsuke Kagawa ,&nbsp;Rie Tamura ,&nbsp;Yoshikazu Matsuoka ,&nbsp;Hiroshi Morimatsu ,&nbsp;Toshiharu Mitsuhashi ,&nbsp;Toshiyoshi Fujiwara","doi":"10.1016/j.jgo.2024.101837","DOIUrl":"10.1016/j.jgo.2024.101837","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"15 8","pages":"Article 101837"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospital admissions in the last month of life for patients with advanced cancer residing in nursing homes","authors":"Gabriela Spulber ,&nbsp;Linda Björkhem-Bergman ,&nbsp;Torbjörn Schultz ,&nbsp;Peter Strang","doi":"10.1016/j.jgo.2024.102048","DOIUrl":"10.1016/j.jgo.2024.102048","url":null,"abstract":"<div><h3>Introduction</h3><div>Overtreatment and frequent hospital admissions in patients at end-of-life has been shown in several studies, including in the nursing home (NH) setting. However, overtreatment in NH residents with advanced cancer has not been studied before. Our objective was to compare emergency room (ER) visits and hospital admissions in the last month of life and place of death among NH residents with or without advanced cancer.</div></div><div><h3>Materials and Methods</h3><div>This retrospective study is based on Region Stockholm's administrative database from 2015 to 2019. Demographic data, ER visits, and Hospital Frailty Risk Score (HFRS) were extracted for each subject. Univariable and multivariable analyses were performed, and odds ratios (OR) calculated.</div></div><div><h3>Results</h3><div>In total, 30,324 NH residents were identified, of which 1807 had advanced cancer. Advanced cancer was associated with more ER visits in the last month of life in the univariable analysis but not when adjusted for age, sex, and risk of frailty with an adjusted aOR of 1.07 (95 %CI 0.97–1.19). Having a cancer diagnosis was significantly associated with acute hospital admissions, although the association was rather weak with an aOR 1.13 (95 %CI 1.02–1.26). NH residents with advanced cancer were less likely to die in hospital than non-cancer residents: aOR 0.63 (95 %CI 0.54–0.73).</div></div><div><h3>Discussion</h3><div>NH residents with advanced cancer have a slightly higher risk of hospital admissions in the last month of life compared to non-cancer residents but are less likely to die in hospital. The probability of ER visits during the last month of life was similar between NH residents with and without cancer.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"15 8","pages":"Article 102048"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Support roles, carer burden, and decision-making preferences of carers of older adults with cancer","authors":"Wing Sze Lindsay Chan ,&nbsp;Vasi Naganathan ,&nbsp;Abby Fyfe ,&nbsp;Alina Mahmood ,&nbsp;Arnav Nanda ,&nbsp;Anne Warby ,&nbsp;Duong Pham ,&nbsp;Natalie Southi ,&nbsp;Sarah Sutherland ,&nbsp;Erin Moth","doi":"10.1016/j.jgo.2024.102079","DOIUrl":"10.1016/j.jgo.2024.102079","url":null,"abstract":"<div><h3>Introduction</h3><div>Older adults with cancer value the perspectives of significant others and their carers regarding decision-making about treatment. Understanding the support provided by carers, and their perspectives on involvement in treatment decision-making, can help us improve our communication with patients and their supports. We aimed to describe the roles, burden, and decision-making preferences of carers of older adults with cancer.</div></div><div><h3>Materials and Methods</h3><div>We performed a cross-sectional survey of carers of older adults (≥65y) with cancer at three centres in Sydney, Australia. Type, frequency, and perspectives on providing care were evaluated using Likert scales. Preferred and perceived role in treatment decision-making by modified Control Preferences Scale, and carer burden by Zarit Burden Index (ZBI-12), were evaluated. Preferred role in decision-making and carer burden were compared between groups (culturally and linguistically diverse backgrounds [CALD], sex, and carer age ≥ 65) by chi-squared or <em>t</em>-tests.</div></div><div><h3>Results</h3><div>One-hundred and fourteen returned surveys were included (23 partially completed). Carer characteristics: median age 55y (range 24–90), female (74 %), child (49 %) and spouse (35 %) of the care-recipient. Care-recipient characteristics: median age 75y (range 65–96), receiving anti-cancer treatment (85 %), and CALD background (44 %). Carers were frequently involved in communication and information gathering (45 % -80 %) and supported instrumental activities of daily living (IADLs) (43 % - 81 %) more frequently than basic activities of daily living (ADLs) (2–13 %). Most (91 %) preferred to be present when treatment options were discussed. Their preferred role in treatment decision-making was passive in 66 %, collaborative in 30 %, and active in 4 %, with most (72 %) playing their preferred role. The preferred role was associated with carer age (<em>p</em> = 0.01) and CALD background (<em>p</em> = 0.04), with younger (&lt;65y) carers and those caring for CALD older adults preferring a more passive role. Carer burden was ‘low’ in 29 %, ‘moderate’ in 31 %, and ‘high’ in 39 %, and providing psychological support was rated most challenging.</div></div><div><h3>Discussion</h3><div>Carers of older adults with cancer play varied support roles, particularly in communication and information gathering. Carers prefer to be present for discussions about treatment options, though favour a passive role in treatment decision-making, upholding patient autonomy. Understanding the communication preferences of carers is an important consideration when supporting the patient in deciding treatment options and direction of care.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"15 8","pages":"Article 102079"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Providing early access to geriatric oncology services in a regional cancer centre - A two-year experience in the establishment of a Geriatric Oncology Nurse Navigator Model.","authors":"Sebastian Kang, Sally Allen, Amy Brown, Dinuka Ariyarathna, Sabe Sabesan, Corinne Ryan, Suresh Varma, Zulfiquer Otty, Abhishek Joshi, Shivanshan Pathmanathan","doi":"10.1016/j.jgo.2024.102145","DOIUrl":"https://doi.org/10.1016/j.jgo.2024.102145","url":null,"abstract":"<p><strong>Introduction: </strong>Older patients with cancer often face increased risks of adverse reactions and complications when undergoing systemic therapy. In 2020, the Townsville Cancer Centre in North Queensland established a nurse navigator led geriatric oncology service for patients aged 75 years and above referred for systemic therapy for solid organ malignancy. This study sought to evaluate the safety outcomes and trends in the administration of systemic therapy in older patients following the introduction of this service.</p><p><strong>Materials and methods: </strong>A retrospective study was conducted at a single centre, focusing on patients aged 75 years and above referred for chemotherapy or immunotherapy for solid organ malignancies. Patients referred after the implementation of the service were classified as the geriatric assessment cohort, while those referred before were categorized as the historical cohort. Outcome measures included unplanned hospital admissions, duration of hospital stays, rates of systemic therapy de-escalation, and frailty identified during geriatric assessments.</p><p><strong>Results: </strong>The study included 129 patients, with 60 in the geriatric assessment cohort and 69 in the historical cohort. The geriatric assessment cohort exhibited a significant decrease in both the average number of hospital admissions per patient compared to the historical cohort (0.59 vs. 1.13, p = 0.01) and the average length of hospital stay (4.3 days vs. 6.7 days, p = 0.04). Rates of systemic therapy de-escalation were comparable between the two cohorts (47 % vs. 59 %, p = 0.16). Frailty was frequently identified during geriatric assessments, requiring intervention both before and during treatment.</p><p><strong>Discussion: </strong>Our two-year observation of the nurse navigator-led geriatric oncology model suggests that it contributed to improved safety outcomes, leading to reductions in unplanned hospitalizations and lengths of hospital stays, without significant changes in the rates of de-escalated systemic therapy.</p>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":" ","pages":"102145"},"PeriodicalIF":3.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}