Journal of geriatric oncology最新文献

英文中文

Tolerability of immune checkpoint inhibitors for cancer treatment in frail, older patients 免疫检查点抑制剂对虚弱老年患者癌症治疗的耐受性。

IF 2.7 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-12-15 DOI: 10.1016/j.jgo.2025.102829

Rochelle Sheppard , Christopher Anstey , Leila Hanjani , Rahul Ladwa , Robin Berry , James Fletcher , Ruth Hubbard

Introduction

Immune checkpoint inhibitors (ICIs) are increasingly used in older adults, but tolerability among frail patients remains uncertain. This study examined immune-related adverse events (irAEs) and treatment outcomes in frail and non-frail adults aged ≥65 years.

Materials and methods

A retrospective single-centre review was conducted at Princess Alexandra Hospital (Queensland, Australia) of patients aged ≥65 who commenced at least one cycle of ICI between December 2021 and July 2023. Frailty was assessed using the Australian 58-item Frailty Index (FI) (non-frail <0.25, frail ≥0.25). The primary outcome was any irAE as defined by Common Terminology Criteria for Adverse Events (CTCAE v5). Secondary outcomes included treatment discontinuation, cycles, interruptions, and corticosteroid use. Univariable and multivariable logistic regression modelling was performed, adjusting for age, sex, cycles, tumour type, stage, concurrent therapy, and Eastern Cooperative Oncology Group Performance Status (ECOG-PS).

Results

Of 122 adults (mean age 75.8 years, 66.4 % male), 51 (41.8 %) were frail. Twenty patients were still receiving ICIs and had not yet completed treatment at last census, leaving 102 records with evaluable outcomes for the final modelling. Any irAE occurred in 53 non-frail adults (74.7 %) and 28 frail adults (54.9 %) (adjusted OR 0.41, 95 % CI 0.19–0.89, p = 0.02). Non-frail adults had more grade 1 events (62.0 % vs 43.1 %, p = 0.045) and skin-related events (48 % vs 27 %, p = 0.04). Grade ≥ 3 events occurred in 11.3 % non-frail vs 11.8 % frail (OR 1.10, 95 % CI 0.38–3.17). Early discontinuation was 60.6 % in non-frail vs 74.5 % in frail (OR 1.90, 95 % CI 0.86–4.19, p = 0.12). Median cycles were 10 (IQR 4–16) in non-frail vs 6 (IQR 4–11) in frail (p = 0.04).

Discussion

Frailty (FI ≥0.25) was associated with fewer irAEs, but frail adults received fewer cycles. These findings are exploratory and should be interpreted cautiously as differences in exposure likely confound toxicity comparisons; time-to-event analyses are warranted.

免疫检查点抑制剂（ICIs）越来越多地用于老年人，但虚弱患者的耐受性仍不确定。这项研究调查了年龄≥65岁的体弱和非体弱成年人的免疫相关不良事件（irAEs）和治疗结果。材料和方法：在亚历山德拉公主医院（昆士兰，澳大利亚）对年龄≥65岁且在2021年12月至2023年7月期间至少开始一个周期ICI的患者进行了回顾性单中心评价。使用澳大利亚58项虚弱指数（FI）评估虚弱(非虚弱结果：122名成年人（平均年龄75.8岁，男性占66.4 %），51人（41.8%）虚弱。在最后一次人口普查中，20名患者仍在接受综合免疫系统，尚未完成治疗，留下102份记录，可供最终建模评估。53名非体弱成人（74.7%）和28名体弱成人（54.9%）发生了irAE（校正OR 0.41, 95% CI 0.19-0.89, p = 0.02）。非虚弱的成年人有更多的1级事件（62.0% vs 43.1%, p = 0.045）和皮肤相关事件（48% vs 27%, p = 0.04）。发生≥3级事件的非虚弱患者为11.3%，虚弱患者为11.8% （OR 1.10, 95% CI 0.38-3.17）。非虚弱组早期停药率为60.6%，虚弱组为74.5% （OR 1.90, 95% CI 0.86-4.19, p = 0.12）。非虚弱组中位周期为10 (IQR 4-16)，虚弱组为6 (IQR 4-11) （p = 0.04）。讨论：虚弱（FI≥0.25）与较少的irae相关，但虚弱的成年人接受较少的周期。这些发现是探索性的，应谨慎解释，因为暴露的差异可能混淆毒性比较；时间到事件的分析是必要的。

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引用次数: 0

Critical assessment of geriatric oncology guidelines based on the AGREE II tool 基于AGREE II工具的老年肿瘤学指南的关键评估。

IF 2.7 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-12-15 DOI: 10.1016/j.jgo.2025.102833

Gayathri Nair , Cailyn H. Livingstone , Jonathon W. Vundum , Mathew George

Introduction

The world's population is aging rapidly and older adults carry a disproportionate cancer burden. Despite this, older patients remain underrepresented in clinical research. As a result, the evidence base informing guideline development remains limited. Existing guidelines vary in methodological quality and applicability. We aimed to evaluate the quality and clinical applicability of established geriatric oncology guidelines using the Appraisal of Guidelines Research and Evaluation, version II (AGREE II) instrument.

Materials and methods

A systematic search was conducted across PubMed, Embase, and the Cochrane Library, in addition to official oncology society websites (ASCO, NCCN, SoFOG, Japanese Geriatric Oncology Group). The search covered publications from January 2000 to May 2025 and was limited to English and to guidelines that specifically address cancer care in older adults and provide documented methodologies. Two reviewers independently appraised each guideline using the AGREE II tool across six domains: scope and purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability, and editorial independence.

Results

A total of 807 records were identified,out of which only 6 guidelines met the eligibility criteria. The AGREE II assessment revealed significant variability in guideline quality. Most guidelines scored high in clarity of presentation and scope and purpose, but showed moderate to low scores in stakeholder involvement and applicability. The recent ASCO guidelines demonstrated higher overall methodological rigor, whereas others lacked comprehensive documentation of evidence synthesis and user applicability.

Discussion

While several geriatric oncology guidelines demonstrate acceptable quality, inconsistencies remain, particularly in stakeholder engagement and practical implementation. Enhanced methodological rigor and inclusive development processes are essential for future guideline improvement and effective translation into geriatric oncology practice.

导言：世界人口正在迅速老龄化，老年人承担着不成比例的癌症负担。尽管如此，老年患者在临床研究中的代表性仍然不足。因此，指导方针制定的证据基础仍然有限。现有指南在方法质量和适用性方面各不相同。我们的目的是使用指南研究和评估评估II版（AGREE II）工具评估已建立的老年肿瘤学指南的质量和临床适用性。材料和方法：系统检索PubMed， Embase， Cochrane图书馆，以及官方肿瘤学会网站（ASCO， NCCN, SoFOG, Japanese Geriatric oncology Group）。检索涵盖了2000年1月至2025年5月的出版物，仅限于英文和专门针对老年人癌症护理的指南，并提供记录的方法。两名审稿人使用AGREE II工具在六个领域独立评估每个指南：范围和目的、涉众参与、开发的严谨性、表达的清晰度、适用性和编辑独立性。结果：共识别807条记录，其中只有6条指南符合入选标准。AGREE II评估显示指南质量存在显著差异。大多数指南在表述的清晰度、范围和目的方面得分很高，但在涉众参与和适用性方面得分中等到较低。最近的ASCO指南显示出更高的总体方法严谨性，而其他指南缺乏证据综合和用户适用性的全面文件。讨论：虽然一些老年肿瘤学指南表现出可接受的质量，但仍然存在不一致性，特别是在利益相关者参与和实际实施方面。增强方法的严谨性和包容性的发展过程对于未来指南的改进和有效地转化为老年肿瘤学实践至关重要。

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引用次数: 0

Adding comprehensive geriatric assessment to standard of care in older patients with frailty and hematological cancer: A pilot and feasibility study 在老年虚弱和血液病患者的标准护理中加入综合老年评估：一项试点和可行性研究

IF 2.7 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-12-13 DOI: 10.1016/j.jgo.2025.102835

Nina Andersen , Ann Kristine Weber Giger , Dana Audrey Lawrie , Wee Kheng Soo , Cecilia Margareta Lund , Jesper Ryg , Henrik Frederiksen

引用次数: 0

Time to modernise research in geriatric oncology: Reflections from the 2025 International Society of Geriatric Oncology Annual Meeting 是时候实现老年肿瘤研究的现代化了：来自2025年国际老年肿瘤学会年会的反思。

IF 2.7 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-12-13 DOI: 10.1016/j.jgo.2025.102837

Sophie Pilleron

引用次数: 0

Exploring decisional control preferences in older patients with cancer and their caregivers 探讨老年癌症患者及其照顾者的决策控制偏好

IF 2.7 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-12-12 DOI: 10.1016/j.jgo.2025.102832

Sofiia Hryniv , Elizabeth Gilbride , William Consagra , Supriya Mohile , Sule Yilmaz , Kaitlin Kyi , Sindhuja Kadambi , Marielle Jensen-Battaglia , Nikesha Gilmore , Mary Whitehead , Jamil Khatri , Fadi S. Braiteh , Alison Conlin , Kah Poh Loh , Allison Magnuson

Introduction

Exploring informational and decisional control preferences as well as examining concordance and patient-caregiver-physician factors associated with preferences in older adults with cancer and their caregivers may help to better understand the role of caregivers in supporting decision-making.

Materials and methods

We utilized data from a national geriatric assessment (GA) cluster-randomized trial (NCT 02054741; PI: Mohile) that recruited patients aged ≥70 with incurable cancer, their caregivers, and oncologists. Dyadic decision-making control preferences were measured by the Control Preferences Scale (CPS). Patients and caregivers were asked to describe patient's role in treatment decision-making (patient-role CPS); patients and caregivers were also asked to describe the caregiver's role in treatment decision-making (caregiver-role CPS). Matching patient-caregiver responses were considered concordant. Patients and caregivers were also asked about their information preferences regarding the amount of detail about the patients' illness using a scale from 1 (fewest detail) to 5 (the most detail). We used descriptive statistics to summarize CPS, informational preferences, and concordance in responses. We utilized logistic regression to assess dyads' sociodemographic information, patients' GA domain impairments, and physicians' practice characteristics associated with patient-caregiver CPS concordance.

Results

A total of 332 dyads participated; mean age (SD) of patients and caregivers was 76.6 (5.3) and 66.6 (12.2), respectively. Preferences for treatment decision-making varied, with some preferring shared decision-making and others preferring the doctor to make decisions. Concordance between patients and caregivers was observed in 46 % for patient-role CPS and 54 % for caregiver-role CPS. Baseline factors were not associated with dyad concordance. The majority of patients and caregivers preferred the most detailed information about the patient's illness.

Discussion

Clinicians should assess patients' and caregivers' informational and decisional control preferences for optimal support in decision-making.

探索信息和决策控制偏好，以及检查与老年癌症患者及其护理人员偏好相关的一致性和患者-护理人员-医生因素，可能有助于更好地理解护理人员在支持决策中的作用。材料和方法我们使用了一项国家老年评估（GA）集群随机试验（NCT 02054741; PI: mohiile）的数据，该试验招募了年龄≥70岁的无法治愈的癌症患者、他们的护理人员和肿瘤学家。采用控制偏好量表（CPS）测量二元决策控制偏好。患者和护理人员被要求描述患者在治疗决策中的角色（患者-角色CPS）；患者和照顾者也被要求描述照顾者在治疗决策中的角色（照顾者-角色CPS）。匹配的患者-护理者反应被认为是和谐的。患者和护理人员也被问及他们对患者疾病细节数量的信息偏好，使用从1（最少细节）到5（最细节）的量表。我们使用描述性统计来总结CPS、信息偏好和响应的一致性。我们使用逻辑回归来评估与患者-护理人员CPS一致性相关的二人组的社会人口统计信息、患者的GA域损伤和医生的实践特征。结果共332人参加；患者和护理人员的平均年龄（SD）分别为76.6岁（5.3岁）和66.6岁（12.2岁）。人们对治疗决策的偏好各不相同，一些人更喜欢共同决策，而另一些人更喜欢医生做决定。患者和护理人员之间的一致性在46%的患者角色CPS和54%的护理人员角色CPS中被观察到。基线因素与双染色体一致性无关。大多数患者和护理人员更喜欢关于患者疾病的最详细的信息。临床医生应该评估患者和护理人员的信息和决策控制偏好，以获得最佳的决策支持。

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引用次数: 0

Safety of CDK4/6 inhibitors in older patients: A FAERS-based analysis of serious and fatal adverse events CDK4/6抑制剂在老年患者中的安全性：基于faers的严重和致命不良事件分析

IF 2.7 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-12-11 DOI: 10.1016/j.jgo.2025.102820

Fausto Petrelli , Alessandro Iaculli , Maria Chiara Parati , Karen Borgonovo , Mara Ghilardi , Veronica Lonati , Irene Angeli , Lorenzo Dottorini

Introduction

CDK4/6 inhibitors—abemaciclib, palbociclib, and ribociclib—are standard treatments for hormone receptor–positive, ERBB2 (HER2)-negative metastatic breast cancer. However, older adults are underrepresented in clinical trials, and age-related safety data remain limited in real-world settings.

Materials and Methods

We conducted a pharmacovigilance analysis using 44,100 individual case safety reports (ICSRs) from the FDA Adverse Event Reporting System (FAERS) involving patients aged ≥65 years treated with CDK4/6 inhibitors. Primary endpoints included serious adverse events (SAEs) and fatal outcomes. A secondary analysis compared adverse events between patients aged <65 and 65–85 years, calculating odds ratios (ORs) for selected toxicities, including death, disease progression, diarrhea, and myelosuppression.

Results

Among older patients, 71.2 % of reports involved SAEs and 5.3 % were fatal. Abemaciclib was linked to higher risk of death in those aged 65–85 compared to younger adults (OR 1.53; 95 % CI 1.18–1.99), but lower odds of myelosuppression (OR 0.37; 95 % CI 0.26–0.53). Palbociclib showed similar death risk across age groups (OR 0.98; 95 % CI 0.92–1.05) and reduced risk of disease progression in older adults (OR 0.72; 95 % CI 0.61–0.84). Ribociclib showed no significant age-related difference in fatality (OR 1.01; 95 % CI 0.87–1.17) but had the highest overall death risk (OR 9.14 vs palbociclib; 95 % CI 7.70–10.84).

Discussion

Real-world data reveal drug- and age-specific toxicity differences. Ribociclib and abemaciclib pose higher risks in older adults compared to palbociclib, supporting the need for personalized treatment and careful monitoring in older patients.

cdk4 /6抑制剂abemaciclib、palbociclib和ribociclib是激素受体阳性、ERBB2 （HER2）阴性转移性乳腺癌的标准治疗药物。然而，老年人在临床试验中的代表性不足，与年龄相关的安全性数据在现实环境中仍然有限。材料和方法我们对来自FDA不良事件报告系统（FAERS）的44,100例个体安全报告（ICSRs）进行了药物警戒分析，涉及年龄≥65岁的CDK4/6抑制剂治疗患者。主要终点包括严重不良事件（SAEs）和致命结局。第二项分析比较了65岁和65 - 85岁患者的不良事件，计算了所选毒性的优势比（or），包括死亡、疾病进展、腹泻和骨髓抑制。结果在老年患者中，71.2%的报告涉及SAEs， 5.3%的报告死亡。与年轻人相比，Abemaciclib与65-85岁患者的死亡风险相关（OR 1.53; 95% CI 1.18-1.99），但骨髓抑制的风险较低（OR 0.37; 95% CI 0.26-0.53）。帕博西尼在各年龄组显示相似的死亡风险（OR 0.98; 95% CI 0.92-1.05），老年人疾病进展风险降低（OR 0.72; 95% CI 0.61-0.84）。Ribociclib在病死率方面没有显着的年龄相关差异（OR 1.01; 95% CI 0.87-1.17），但总体死亡风险最高（OR 9.14 vs palbociclib; 95% CI 7.70-10.84）。真实世界的数据揭示了药物和年龄特异性的毒性差异。与帕博西尼相比，Ribociclib和abemaciclib在老年人中具有更高的风险，这支持了老年患者个性化治疗和仔细监测的必要性。

{"title":"Safety of CDK4/6 inhibitors in older patients: A FAERS-based analysis of serious and fatal adverse events","authors":"Fausto Petrelli , Alessandro Iaculli , Maria Chiara Parati , Karen Borgonovo , Mara Ghilardi , Veronica Lonati , Irene Angeli , Lorenzo Dottorini","doi":"10.1016/j.jgo.2025.102820","DOIUrl":"10.1016/j.jgo.2025.102820","url":null,"abstract":"<div><h3>Introduction</h3><div>CDK4/6 inhibitors—abemaciclib, palbociclib, and ribociclib—are standard treatments for hormone receptor–positive, ERBB2 (HER2)-negative metastatic breast cancer. However, older adults are underrepresented in clinical trials, and age-related safety data remain limited in real-world settings.</div></div><div><h3>Materials and Methods</h3><div>We conducted a pharmacovigilance analysis using 44,100 individual case safety reports (ICSRs) from the FDA Adverse Event Reporting System (FAERS) involving patients aged ≥65 years treated with CDK4/6 inhibitors. Primary endpoints included serious adverse events (SAEs) and fatal outcomes. A secondary analysis compared adverse events between patients aged <65 and 65–85 years, calculating odds ratios (ORs) for selected toxicities, including death, disease progression, diarrhea, and myelosuppression.</div></div><div><h3>Results</h3><div>Among older patients, 71.2 % of reports involved SAEs and 5.3 % were fatal. Abemaciclib was linked to higher risk of death in those aged 65–85 compared to younger adults (OR 1.53; 95 % CI 1.18–1.99), but lower odds of myelosuppression (OR 0.37; 95 % CI 0.26–0.53). Palbociclib showed similar death risk across age groups (OR 0.98; 95 % CI 0.92–1.05) and reduced risk of disease progression in older adults (OR 0.72; 95 % CI 0.61–0.84). Ribociclib showed no significant age-related difference in fatality (OR 1.01; 95 % CI 0.87–1.17) but had the highest overall death risk (OR 9.14 vs palbociclib; 95 % CI 7.70–10.84).</div></div><div><h3>Discussion</h3><div>Real-world data reveal drug- and age-specific toxicity differences. Ribociclib and abemaciclib pose higher risks in older adults compared to palbociclib, supporting the need for personalized treatment and careful monitoring in older patients.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102820"},"PeriodicalIF":2.7,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145735292","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}

引用次数: 0

Do we need geriatricians in geriatric oncology? A SIOG geriatricians position statement 我们需要老年肿瘤学专家吗？SIOG老年病专家的立场声明

IF 2.7 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-12-11 DOI: 10.1016/j.jgo.2025.102831

Carolina Gómez-Moreno , Chiara Russo , Armida Parala-Metz , Bérengère Beauplet , Anupa Pillai , Anand Kumar , Domenico Fusco , Suzanne Festen , Siri Rostoft

引用次数: 0

BDNF genotype and cognition in older adults with breast cancer and healthy controls in the Thinking and Living with Cancer Study 老年乳腺癌患者及健康对照者的BDNF基因型与认知

IF 2.7 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-12-10 DOI: 10.1016/j.jgo.2025.102834

Zev M. Nakamura , Brent J. Small , Xingtao Zhou , Jaeil Ahn , Tim A. Ahles , Ashley L. Artese , Harvey Jay Cohen , Martine Extermann , Deena Graham , Claudine Isaacs , Heather S.L. Jim , Brenna C. McDonald , Kelly Nudelman , Sunita K. Patel , Kelly E. Rentscher , James C. Root , Andrew J. Saykin , Kathleen Van Dyk , Claire E. Wegel , Jeanne S. Mandelblatt , Judith E. Carroll

引用次数: 0

Reflections on treatment decision making in older adults with cancer 对老年癌症患者治疗决策的思考。

IF 2.7 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-12-08 DOI: 10.1016/j.jgo.2025.102830

Vincent E.S. Allott , Michael B. Fertleman , Louis J. Koizia , Benjamin H.L. Harris

引用次数: 0

Dizziness and impaired postural balance in older patients receiving chemotherapy treatment: A systematic review and meta-analysis 接受化疗的老年患者的头晕和体位平衡受损：一项系统回顾和荟萃分析

IF 2.7 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-12-05 DOI: 10.1016/j.jgo.2025.102816

Katrine Storm Piper , Martine Puts , Cecilia Lund , Jesper Ryg , Charlotte Suetta , Hanne Elkjær Andersen , Jakob Vasehus Schou , Allan Madsen , Jan Christensen

Introduction

Dizziness and balance impairments are underexplored symptoms in older adults with cancer. Age-related factors, comorbidities, and chemotherapy may contribute to its prevalence and severity, potentially affecting quality of life, increasing fall risk, and delaying treatment. Data on the incidence and prevalence of these symptoms are limited. This systematic review aimed to summarize the evidence and estimate the incidence and prevalence of dizziness or vertigo and impaired postural balance in patients with cancer ≥65 years receiving chemotherapy.

Materials and Methods

We searched PubMed, EMBASE, CENTRAL, and CINAHL in May 2025 without date or language restrictions. Cross sectional studies, cohort studies, randomized controlled trials, and mixed method studies investigating incidence and/or prevalence of dizziness or vertigo and impaired postural balance were included. Random-effects meta-analysis, employing the inverse-variance method, was applied. Certainty of evidence was rated by the Grading of Recommendations Assessment and Evaluation (GRADE) approach.

Results

From 15,614 title/abstracts screened, 14 studies (1259 participants) were included. Incidence could not be evaluated. Studies reporting prevalence across multiple chemotherapy regimens contributed separate estimates for each regimen. Meta-analysis included 25 prevalence estimates for dizziness and three for impaired postural balance. The pooled prevalence of dizziness was 15 % (95 % CI:10 %–22 %). Assessor-reported prevalence using the Common Terminology Criteria for Adverse Events (CTCAE) was 11 % (95 % CI: 8 %–16 %), while patient-reported prevalence rate using the European Organisation for Research and Treatment of Cancer Chemotherapy Induced Peripheral Neuropathy Questionnaire (EORTC QLQ-CIPN20), or a self-constructed questionnaire was 35 % (95 % CI: 20 %–53 %). Most studies demonstrated a high risk of bias, and certainty of evidence was very low due to unstructured assessor-reported measurement methods. Impaired postural balance prevalence from one study was 48 % (95 % CI: 39 %–57 %) with low certainty of evidence. Prevalence of dizziness and impaired postural balance did not differ significantly across chemotherapy regimens.

Discussion

Prevalence of dizziness and impaired postural balance in older patients receiving chemotherapy varied substantially depending on the measurement method, with higher rates in patient-reported outcomes. Certainty of evidence was low primarily due to limitations in outcome measures. Future studies should incorporate patient-reported outcome measures and a systematic objective baseline assessment for a comprehensive evaluation of these symptoms.

Trial registration: PROSPERO CRD42024585974.

老年癌症患者的头晕和平衡障碍尚未得到充分的研究。年龄相关因素、合并症和化疗可能导致其流行和严重程度，可能影响生活质量、增加跌倒风险和延迟治疗。关于这些症状的发生率和流行率的数据有限。本系统综述旨在总结证据并估计≥65岁接受化疗的癌症患者头晕或眩晕和姿势平衡受损的发生率和患病率。材料和方法我们检索了PubMed， EMBASE， CENTRAL和CINAHL于2025年5月，无日期和语言限制。包括横断面研究、队列研究、随机对照试验和混合方法研究，调查头晕或眩晕的发病率和/或患病率以及姿势平衡受损。采用反方差法进行随机效应meta分析。证据的确定性是通过分级建议评估和评价（GRADE）方法来评定的。结果从15614篇标题/摘要中筛选出14篇研究（1259名受试者）。发病率无法评估。研究报告了多种化疗方案的患病率，对每种方案提供了单独的估计。荟萃分析包括25例眩晕患病率估计和3例姿势平衡受损。眩晕的总患病率为15% （95% CI: 10% - 22%）。使用不良事件通用术语标准（CTCAE）评估者报告的患病率为11% (95% CI: 8% - 16%)，而使用欧洲癌症化疗诱导周围神经病变研究和治疗组织问卷（EORTC QLQ-CIPN20）或自编问卷的患者报告患病率为35% （95% CI: 20% - 53%）。大多数研究表明存在较高的偏倚风险，而且由于评估者报告的测量方法非结构化，证据的确定性非常低。一项研究中，姿势平衡受损的患病率为48% (95% CI: 39% - 57%)，证据的确定性较低。在不同的化疗方案中，头晕和姿势平衡受损的发生率没有显著差异。在接受化疗的老年患者中，眩晕和姿势平衡受损的患病率因测量方法的不同而有很大差异，在患者报告的结果中有较高的发生率。证据的确定性较低，主要是由于结果测量的局限性。未来的研究应纳入患者报告的结果测量和系统的客观基线评估，以全面评估这些症状。试验注册：PROSPERO CRD42024585974。

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