[肿瘤学中的虚弱:临床实践的最新建议]。

Deutsche medizinische Wochenschrift (1946) Pub Date : 2024-08-01 Epub Date: 2024-08-15 DOI:10.1055/a-2115-0583
Valentin Goede, Ulrich Wedding
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引用次数: 0

摘要

虚弱是一种与衰老相关的临床症状,会导致在外源性或内源性压力下出现不良后果的风险增加。在肿瘤学中,癌症治疗本身就是一种压力事件。因此,对于老年癌症患者来说,虚弱不仅会增加与年龄相关的健康事件(如住院或跌倒)的发生概率,还会增加治疗并发症(如毒性、治疗中断或中止)的发生概率。最近在接受系统治疗的老年癌症患者中开展的随机对照试验表明,通过老年评估(GA)对老年虚弱进行评估,然后调整肿瘤治疗以及采取有针对性的老年虚弱干预措施,有助于提高癌症治疗的耐受性和可行性。基于这些数据,美国临床肿瘤学会(ASCO)更新了关于评估和管理接受系统性癌症治疗的老年人脆弱性的临床实践指南。该指南建议使用一种名为 "实用老年评估"(PGA)的新老年评估工具,以促进在常规癌症治疗中实施基于老年评估的虚弱评估和管理。本文介绍了这些最新进展的背景和主要方面。
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[Frailty in Oncology: Updated Recommendations for Clinical Practice].

Frailty is a clinical condition associated with aging and resulting in increased risk of adverse outcomes upon exogenous or endogenous stressors. In oncology, cancer treatment itself can be a stressor event. In older cancer patients, frailty therefore not only enhances the probability of age-related health events such as institutionalization or falls, but also of treatment complications such as toxicity and interruption or discontinuation of therapy. As demonstrated by recent randomized-controlled trials conducted in older cancer patients receiving systemic treatment, the evaluation of frailty by geriatric assessment (GA) followed by an adjustment of the oncological therapy as well as targeted frailty interventions help to improve cancer treatment tolerability and feasibility. Based on these data, the American Society of Clinical Oncology (ASCO) updated the clinical practice guidelines for the assessment and management of vulnerabilities in older adults receiving systemic cancer therapy. The guideline recommends the use of a new GA-tool named 'practical geriatric assessment' (PGA) to foster the implementation of GA-based frailty assessment and management in routine cancer care. This article describes the background and key aspects of these recent advances.

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