Journal of geriatric oncology最新文献

英文中文

Personalized risk assessment of frailty in long-term cancer survivors 长期癌症幸存者虚弱的个性化风险评估

IF 2.7 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-11-29 DOI: 10.1016/j.jgo.2025.102804

Rebecca Forman , Sarah J. Westvold , Jessica B. Long , Jane Fan , Terry Hyslop , Kerry Conlin , Sofia Jacobson , Shi-Yi Wang , Michael S. Leapman , Michael Cecchini , Ira Leeds , Lisa Spees , Carolyn Presley , Faiza Yasin , Melissa Taylor , Tendai Kwaramba , Cary P. Gross , Kevin Oeffinger , Michaela A. Dinan

Introduction: Due to the growth of the cancer survivor population, strategies to facilitate efficient delivery of survivorship care are critical to reduce the risk of adverse events associated with frailty. The objective of this study was to develop a risk stratification tool to identify long-term survivors at the highest risk of becoming frail 5–10 years after cancer diagnosis.

Materials and Methods: We used the Surveillance, Epidemiology, and End Results (SEER) dataset linked with Medicare data to identify patients with stage I-III breast, prostate, colon, or rectal cancers who lived at least five years from diagnosis and were not severely frail at year five post-diagnosis. Frailty was assessed using the claims-based Kim Frailty Index (FI) categorized by recommended thresholds. Restricted mean survival time (RMST) regression was used to identify clinical and demographic characteristics associated with frailty progression, defined as an increased category of the FI. Significant predictors were used to create clinical prediction rules and stratify survivors into low, intermediate, and high-risk groups.

Results: A total of 87,229 five-year survivors were included. At five years from diagnosis (time zero), 22 % of patients not frail at cancer diagnosis had new onset frailty and were mildly or moderately frail; at 10 years from diagnosis, 61 % had developed new or worsening frailty. Advanced age, comorbidities (RMST ratios ranging from 0.67 [95 % CI 0.65–0.70] to 0.80 [95 % CI 0.77–0.84], baseline moderate frailty at cancer diagnosis (RMST ratios ranging from 0.79 [95 % CI 0.76–0.83] to 0.86 [95 % CI 0.83–0.90]) and at five years post-diagnosis (RMST ratios ranging from 0.63 [95 % CI 0.62–0.64] to 0.71 [95 % CI 0.69–0.73]), living in a high poverty area (RMST ratios ranging from 0.91 [95 % CI 0.87–0.94] to 0.96, [95 % CI 0.93–0.99], and systemic treatments four to five years post-diagnosis (RMST ratios ranging from 0.77 [95 % CI: 0.70–0.84] to 0.86, [95 % CI: 0.84–0.89] were associated with less average time without frailty.

Discussion: Age, comorbidities, prior frailty, and late treatment were associated with frailty in older breast, prostate, colon, and rectal cancer survivors. This risk stratification model can be used by clinicians to assess cancer and age-related risk of frailty and facilitate timely intervention.

导言：由于癌症幸存者人口的增长，促进有效提供生存护理的策略对于减少与虚弱相关的不良事件的风险至关重要。本研究的目的是开发一种风险分层工具，以确定癌症诊断后5-10年内身体虚弱风险最高的长期幸存者。材料和方法：我们使用与医疗保险数据相关联的监测、流行病学和最终结果（SEER）数据集来识别I-III期乳腺癌、前列腺癌、结肠癌或直肠癌患者，这些患者在诊断后至少生活了5年，并且在诊断后5年没有严重虚弱。虚弱评估使用索赔为基础的金氏虚弱指数（FI）分类推荐阈值。限制平均生存时间（RMST）回归用于确定与衰弱进展相关的临床和人口学特征，定义为FI的增加类别。显著性预测因子用于建立临床预测规则，并将幸存者分为低、中、高风险组。结果：共纳入87,229例5年生存率。在诊断后5年（零时间），22%的癌症诊断时不虚弱的患者出现了新发虚弱，并且是轻度或中度虚弱；在确诊10年后，61%的人出现了新的或恶化的虚弱。先进的年龄、并发症(RMST比率从0.67 (95% CI 0.65 - -0.70), 0.80 (95% CI 0.77 - -0.84),基线中度脆弱在癌症诊断(RMST比率从0.79 (95% CI 0.76 - -0.83), 0.86 (95% CI 0.83 - -0.90)),在五年内post-diagnosis (RMST比率从0.63 (95% CI 0.62 - -0.64), 0.71 (95% CI 0.69 - -0.73)),生活在一个高贫困地区(RMST比率从0.91 (95% CI 0.87 - -0.94), 0.96 (95% CI 0.93 - -0.99),和诊断后4至5年的全身治疗（RMST比值范围为0.77 [95% CI: 0.70-0.84]至0.86,[95% CI: 0.84-0.89]）与较短的平均无虚弱时间相关。讨论：年龄、合并症、既往虚弱和晚期治疗与老年乳腺癌、前列腺癌、结肠癌和直肠癌幸存者的虚弱相关。这种风险分层模型可以被临床医生用来评估癌症和年龄相关的虚弱风险，并促进及时干预。

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引用次数: 0

More than age: Impact of comorbidity and polypharmacy on immune-related adverse events, treatment discontinuation, and toxicity management in older patients receiving immune checkpoint inhibitors 超过年龄：在接受免疫检查点抑制剂的老年患者中，合并症和多药治疗对免疫相关不良事件、停药和毒性管理的影响

IF 2.7 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-11-17 DOI: 10.1016/j.jgo.2025.102813

Anja Gesierich , Eran Demeter , Bastian Schilling , Barbara Deschler-Baier

引用次数: 0

Important aspects of care and priorities of older patients with cancer: The PRIORITY multicenter cohort study. 老年癌症患者护理的重要方面和优先事项：优先多中心队列研究

IF 2.7 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-11-13 DOI: 10.1016/j.jgo.2025.102812

Thomas Grellety, Carine Bellera, Coralie Cantarel, Cécile Mertens, Mathilde Cabart, Guilhem Roubaud, Marie-Claude Chantecaille, Hervé Desclos, Corinne Souyris, Patrick Bouchaert, Emmanuelle Bourbouloux, Catherine Terret, Cécile Delattre, Laurent Cany, Caroline Lalet, Simone Mathoulin-Pelissier, Pierre Soubeyran, Camille Chakiba Brugere

Introduction: Data on treatment preferences in older cancer patients are lacking. We aimed to identify their priorities.

Materials and methods: We conducted a multicenter prospective cohort study on patients with cancer aged ≥70 and 18-69, initiating first medical treatment. Patients and physicians prioritized eight aspects of care: treatment efficacy, life expectancy, autonomy, daily tasks, social activities, treatment burden, toxicity, and economic burden via self-completed questionnaires. The primary endpoint was the priorities of older patients.

Results: We included 233 older and 100 younger patients at eight sites. In the older patient cohort, median age was 79 (min-max: 70-97), breast cancer represented 34 % (N = 78) and lung 12 % (N = 27). Metastatic setting concerned 45 % of the patients. The most frequently rated top priority at treatment initiation was treatment efficacy in both older (73 %) and younger cohorts (79 %), followed by autonomy in the older cohort (13 %) and life expectancy in the younger cohort (14 %). Treatment efficacy was almost systematically cited in the top four priorities for both older (94 %) and younger patients (96 %), followed by autonomy (86 %) for older and life expectancy (82 %) for younger patients. These priorities were stable (>70 %) between initiation and three months for each cohort. Agreement rate for prioritization of aspects of care between older patients and physicians was 87 % for treatment efficacy and 64 % for autonomy.

Discussion: Autonomy was the second most cited priority among older patients, yet many physicians failed to recognize this, potentially affecting treatment decisions. These findings highlight the need for shared decision-making to align treatment choices with patient expectations.

关于老年癌症患者治疗偏好的数据缺乏。我们的目标是确定他们的优先事项。材料和方法：我们对年龄≥70岁和18-69岁的癌症患者进行了一项多中心前瞻性队列研究，并开始了首次药物治疗。患者和医生通过自填问卷对治疗效果、预期寿命、自主性、日常任务、社交活动、治疗负担、毒性和经济负担八个方面的护理进行优先排序。主要终点是老年患者。结果：我们纳入了8个地点的233名老年患者和100名年轻患者。在老年患者队列中，中位年龄为79岁（最小-最大年龄：70-97岁），乳腺癌占34% (N = 78)，肺癌占12% （N = 27）。45%的患者有转移性。在治疗开始时，最常被评为最优先的是老年队列（73%）和年轻队列（79%）的治疗疗效，其次是老年队列的自主性（13%）和年轻队列的预期寿命（14%）。对于老年患者（94%）和年轻患者（96%），治疗疗效几乎被系统地引用在前四个优先事项中，其次是老年患者的自主性（86%）和年轻患者的预期寿命（82%）。这些优先级在每个队列开始到3个月之间是稳定的（约70%）。老年患者和医生在治疗效果和自主性方面对护理优先顺序的满意率分别为87%和64%。讨论：在老年患者中，自主性是第二大优先事项，然而许多医生没有认识到这一点，这可能会影响治疗决策。这些发现强调了共同决策的必要性，以使治疗选择与患者期望保持一致。

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引用次数: 0

Association between geriatric assessment domains and chemotherapy among older women with breast cancer 老年乳腺癌妇女的老年评估领域与化疗之间的关系。

IF 2.7 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-11-13 DOI: 10.1016/j.jgo.2025.102811

Koshy Alexander , Sacha Roberts , Amy L. Tin , Jasmeet Singh , Diana Lake , Elissa Meditz , Abha Kulkarni , Manpreet Boparai , Beatriz Korc-Grodzicki , Armin Shahrokni

引用次数: 0

Comment on“Survival and risk factors for death in older adults with primary head and neck cancer: A retrospective observational cohort study” 对“老年人原发性头颈癌的生存和死亡危险因素：一项回顾性观察队列研究”的评论

IF 2.7 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-11-08 DOI: 10.1016/j.jgo.2025.102807

Yu Tian , Hui Leng , XiangLong Hao , RuPeng Qu , AiPing Wang

引用次数: 0

Response to letters to the editor 回复给编辑的信件

IF 2.7 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-11-07 DOI: 10.1016/j.jgo.2025.102809

Hanna Kerminen , Esa Jämsen , Saara Markkanen

引用次数: 0

Beyond age and anaemia: A reappraisal of prognostic factors in geriatric head and neck cancer 超越年龄和贫血：对老年头颈癌预后因素的重新评估

IF 2.7 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-11-07 DOI: 10.1016/j.jgo.2025.102808

Brijesh Sathian, Siham Mohammed Al Mushaifri, Ebtehal Obeidat, Hanadi Al Hamad

引用次数: 0

Alcohol consumption in older cancer survivors: An analysis of adherence to the World Cancer Research Fund and American Institute for Cancer Research guidelines 老年癌症幸存者的酒精消费：对世界癌症研究基金会和美国癌症研究协会指南的依从性分析。

IF 2.7 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-11-06 DOI: 10.1016/j.jgo.2025.102810

Cara L. Chase , Zachary L. Chaplow , Colleen Spees , Jade Smith , Jessica L. Krok-Schoen

引用次数: 0

Hospice, palliative care, and care experiences among Medicare beneficiaries with cancer 癌症医疗保险受益人的临终关怀、姑息治疗和护理经验。

IF 2.7 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-11-03 DOI: 10.1016/j.jgo.2025.102795

Lisa M. Lines , Miku Fujita , Kim N. Danforth , Daniel H. Barch , Michael T. Halpern , Michelle A. Mollica , David T. Eton , Ashley Wilder Smith

Introduction

Palliative care (PC), including hospice, can improve quality of life by helping manage distressing symptoms. PC is underutilized among people with cancer in the United States. We studied whether (1) sociodemographics and illness burden were associated with receipt of PC, and (2) whether PC use was related to self-reported care experiences.

Materials and Methods

Using Surveillance, Epidemiology, and End Results (SEER)–Consumer Assessment of Healthcare Providers and Systems (CAHPS) data, we analyzed illness burden (using the SEER-CAHPS Illness Burden Index [SCIBI]), race/ethnicity, and self-reported care experiences in three cancer cohorts: those receiving hospice (with or without other forms of PC); PC encounters without hospice; and no PC. We included fee-for-service and Medicare Advantage beneficiaries with cancer (n = 37,025) diagnosed 2007–2017, surveyed 2007–2017, and followed up to five years post-diagnosis (through 2019). Multivariable survey-weighted logistic regression models adjusted for clinical characteristics, social determinants of health (SDoH) (dual enrollment in Medicare and Medicaid; neighborhood poverty; education; language), demographics, and clinical characteristics.

Results

Among 37,025 Medicare beneficiaries with cancer, 11.1 % received hospice (with or without PC) and 7.4 % received PC only. Nearly 30 % of the sample died within five years of diagnosis; fewer than one-third of decedents received hospice. Factors associated with receiving hospice included increasing age, non-Hispanic ethnicity, American Indian/Alaska Native and multiracial identities, living in higher-income neighborhoods, survey-completion proxy assistance, fair/poor general health, advanced stage at diagnosis, and more illness burden. Independent predictors of PC encounters included age 75–79, female identification, no dual enrollment, no proxy assistance, and more illness burden. Differences in care experience associated with hospice or PC use were shown for two care experience measures: doctor communication scores and doctor rating scores were higher among beneficiaries who received neither hospice nor PC relative to beneficiaries who received hospice.

Discussion

Variability in hospice and PC receipt across sociodemographic characteristics suggest the continued need to ensure equitable service provision. Worse doctor communication scores associated with hospice or PC encounters suggests a potential avenue for improving care experiences.

导言：姑息治疗（PC），包括临终关怀，可以通过帮助控制痛苦症状来改善生活质量。在美国，个人电脑在癌症患者中没有得到充分利用。我们研究了(1)社会人口统计学和疾病负担是否与个人电脑的使用有关，以及(2)个人电脑的使用是否与自我报告的护理经历有关。材料和方法：使用监测、流行病学和最终结果(SEER)-医疗保健提供者和系统的消费者评估（CAHPS）数据，我们分析了三个癌症队列的疾病负担（使用SEER-CAHPS疾病负担指数[SCIBI]）、种族/民族和自我报告的护理经历：接受临终关怀的患者（有或没有其他形式的PC）；没有临终关怀的PC遭遇；没有个人电脑。我们纳入了2007-2017年诊断为癌症的按服务收费和医疗保险优惠受益人（n = 37,025），对2007-2017年进行了调查，并随访至诊断后5年（至2019年）。多变量调查加权logistic回归模型调整了临床特征、健康的社会决定因素（医疗保险和医疗补助双重登记、社区贫困、教育、语言）、人口统计学和临床特征。结果：在37,025名患有癌症的医疗保险受益人中，11.1%接受了临终关怀（有或没有PC）， 7.4%只接受了PC。近30%的样本在确诊后5年内死亡；不到三分之一的死者接受了临终关怀。与接受安宁疗护相关的因素包括年龄增加、非西班牙裔、美洲印第安人/阿拉斯加原住民和多种族身份、生活在高收入社区、调查完成代理援助、一般健康状况一般/较差、诊断阶段较晚和更多疾病负担。PC就诊的独立预测因素包括年龄75-79岁、女性身份、无双入组、无代理援助和更多的疾病负担。与安宁疗护或个人电脑使用相关的疗护经验，在两项疗护经验测量中显示出差异：既不接受安宁疗护也不接受个人电脑的受益人，相较于接受安宁疗护的受益人，医生沟通得分和医生评等得分更高。讨论：不同社会人口特征的安宁疗护和个人护理接收的差异表明，仍需要确保公平的服务提供。较差的医生沟通分数与临终关怀或个人电脑接触有关，这表明改善护理体验的潜在途径。

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引用次数: 0

Implementing a geriatric oncology program in a Midsize Swiss Cancer Center: Feasibility and early results 在瑞士中型癌症中心实施老年肿瘤学项目：可行性和早期结果

IF 2.7 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-11-01 DOI: 10.1016/j.jgo.2025.102461

D. Wirth , M. Vetter , H. Unger , A. Eish

引用次数: 0

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