Does a geriatric oncology consultation modify the cancer treatment plan for elderly patients?

被引:139
作者
Girre, Veronique [1 ]
Falcou, Marie-Christine [1 ]
Gisselbrecht, Mathilde [1 ]
Gridel, Genevieve [1 ]
Mosseri, Veronique [1 ]
Bouleuc, Carole [1 ]
Poinsot, Rollon [1 ]
Vedrine, Lionel [1 ]
Ollivier, Liliane [1 ]
Garabige, Valerie [1 ]
Pierga, Jean-Yves [1 ]
Dieras, Veronique [1 ]
Mignot, Laurent [1 ]
机构
[1] Inst Curie, Dept Med Oncol, F-75005 Paris, France
来源
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES | 2008年 / 63卷 / 07期
关键词
cancer treatment; geriatric assessment; elderly;
D O I
10.1093/gerona/63.7.724
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Background. This study was performed to describe the treatment plan modifications after a geriatric oncology clinic. Assessment of health and functional status and cancer assessment was performed in older cancer patients referred to a cancer center. Patients and Methods. Between June 2004 and May 2005, 105 patients 70 years old or older referred to a geriatric oncology consultation at the Institut Curie cancer center were included. Functional status, nutritional status, mood. mobility, comorbidity, medication, social support. and place of residence were assessed. Oncology data and treatment decisions were recorded before and after this consultation. Data were analyzed for a possible correlation between one domain of the assessment and modification of the treatment plan. Results. Patient characteristics included a median age of 79 years and a predominance of women with breast cancer. About one half of patients had an independent functional status. Nearly 15% presented severe undernourishment. Depression was suspected in 53.1% of cases. One third of these patients had >2 chronic diseases, and 74% of patients took >= 3 medications. Of the 93 patients with an initial treatment decision, the treatment plan was modified for 38.7% of cases after this assessment. Only body mass index and the absence of depressive symptoms were associated with a modification of the treatment plan. Conclusion. The geriatric oncology consultation led to a modification of the cancer treatment plan in more than one third of cases. Further studies are needed to determine whether these modifications improve the outcome of these older patients.
引用
收藏
页码:724 / 730
页数:7
相关论文
共 32 条
[1]   The application of the principles of geriatrics to the management of the older person with cancer [J].
Balducci, L ;
Beghe, C .
CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY, 2000, 35 (03) :147-154
[2]   Undertreatment strongly decreases prognosis of breast cancer in elderly women [J].
Bouchardy, C ;
Rapiti, E ;
Fioretta, G ;
Laissue, P ;
Neyroud-Caspar, I ;
Schäfer, P ;
Kurtz, J ;
Sappino, AP ;
Vlastos, G .
JOURNAL OF CLINICAL ONCOLOGY, 2003, 21 (19) :3580-3587
[3]  
Clement JP, 1997, ENCEPHALE, V23, P91
[4]   Use of BMI in the assessment of undernutrition in older subjects: reflecting on practice [J].
Cook, Z ;
Kirk, S ;
Lawrenson, S ;
Sandford, S .
PROCEEDINGS OF THE NUTRITION SOCIETY, 2005, 64 (03) :313-317
[5]   Depressive symptoms and 3-year mortality in older hospitalized medical patients [J].
Covinsky, KE ;
Kahana, E ;
Chin, MH ;
Palmer, RM ;
Fortinsky, RH ;
Landefeld, CS .
ANNALS OF INTERNAL MEDICINE, 1999, 130 (07) :563-569
[6]   Use of comprehensive geriatric assessment in older cancer patients: Recommendations from the task force on CGA of the International Society of Geriatric Oncology (SIOG) [J].
Extermann, M ;
Aapro, M ;
Bernabei, RB ;
Cohen, HJ ;
Droz, JP ;
Lichtman, S ;
Mor, V ;
Monfardini, S ;
Repetto, L ;
Sorbye, L ;
Topinkova, E .
CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY, 2005, 55 (03) :241-252
[7]   A comprehensive geriatric intervention detects multiple problems in older breast cancer patients [J].
Extermann, M ;
Meyer, J ;
McGinnis, M ;
Crocker, TT ;
Corcoran, MB ;
Yoder, J ;
Haley, WE ;
Chen, HB ;
Boulware, D ;
Balducci, L .
CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY, 2004, 49 (01) :69-75
[8]   Are older French patients as willing as older American patients to undertake chemotherapy? [J].
Extermann, M ;
Albrand, G ;
Chen, HB ;
Zanetta, S ;
Schonwetter, R ;
Zulian, GB ;
Cantor, A ;
Droz, JP .
JOURNAL OF CLINICAL ONCOLOGY, 2003, 21 (17) :3214-3219
[9]  
Frazier Susan C, 2005, J Gerontol Nurs, V31, P4
[10]   Breast cancer treatment guidelines in older women [J].
Giordano, SH ;
Hortobagyi, GN ;
Kau, SWC ;
Theriault, RL ;
Bondy, ML .
JOURNAL OF CLINICAL ONCOLOGY, 2005, 23 (04) :783-791