Marije E Hamaker1, Marthe Te Molder2, Noortje Thielen2, Barbara C van Munster3, Anandi H Schiphorst4, Lieke H van Huis2. 1. Department of Geriatric Medicine, Diakonessenhuis Utrecht, The Netherlands. Electronic address: mhamaker@diakhuis.nl. 2. Department of Internal Medicine, Diakonessenhuis Utrecht, The Netherlands. 3. Deparment of Geriatric Medicine, Gelre Ziekenhuis, Apeldoorn, The Netherlands. 4. Department of Surgery, Diakonessenhuis Utrecht, The Netherlands.
Abstract
AIM: The aim of this systematic review is to summarise all available data on the effect of a geriatric evaluation on the multidisciplinary treatment of older cancer patients, focussing on oncologic treatment decisions, the implementation of non-oncologic interventions and the impact on treatment outcome. METHODS: A systematic search in MEDLINE and EMBASE for studies on the effect of a geriatric evaluation on oncologic and non-oncologic treatment decisions and outcome for older cancer patients. RESULTS: 36 publications from 35 studies were included. After a geriatric evaluation, the oncologic treatment plan was altered in a median of 28% of patients (range 8-54%), primarily to a less intensive treatment option. Non-oncologic interventions were recommended in a median of 72% of patients (range 26-100%), most commonly involving social issues (39%), nutritional status (32%) and polypharmacy (31%). Effect on treatment outcome was varying, with a trend towards a positive effect on treatment completion (positive effect in 75% of studies) and treatment-related toxicity/ complications (55% of studies). CONCLUSION: A geriatric evaluation affects oncologic and non-oncologic treatment and appears to improve treatment tolerance and completion for older cancer patients. Fine-tuning the decision-making process for this growing patient population will require more specific and robust data on the effect of a geriatric evaluation on relevant oncologic and non-oncologic outcomes such as survival and quality of life.
AIM: The aim of this systematic review is to summarise all available data on the effect of a geriatric evaluation on the multidisciplinary treatment of older cancerpatients, focussing on oncologic treatment decisions, the implementation of non-oncologic interventions and the impact on treatment outcome. METHODS: A systematic search in MEDLINE and EMBASE for studies on the effect of a geriatric evaluation on oncologic and non-oncologic treatment decisions and outcome for older cancerpatients. RESULTS: 36 publications from 35 studies were included. After a geriatric evaluation, the oncologic treatment plan was altered in a median of 28% of patients (range 8-54%), primarily to a less intensive treatment option. Non-oncologic interventions were recommended in a median of 72% of patients (range 26-100%), most commonly involving social issues (39%), nutritional status (32%) and polypharmacy (31%). Effect on treatment outcome was varying, with a trend towards a positive effect on treatment completion (positive effect in 75% of studies) and treatment-related toxicity/ complications (55% of studies). CONCLUSION: A geriatric evaluation affects oncologic and non-oncologic treatment and appears to improve treatment tolerance and completion for older cancerpatients. Fine-tuning the decision-making process for this growing patient population will require more specific and robust data on the effect of a geriatric evaluation on relevant oncologic and non-oncologic outcomes such as survival and quality of life.
Authors: Grant R Williams; Kathryn E Weaver; Glenn J Lesser; Emily Dressler; Karen M Winkfield; Heather B Neuman; Anne E Kazak; Ruth Carlos; Lucy J Gansauer; Charles S Kamen; Joseph M Unger; Supriya G Mohile; Heidi D Klepin Journal: Oncologist Date: 2020-08-31
Authors: Ismay N van Loon; Namiko A Goto; Franciscus T J Boereboom; Michiel L Bots; Ellen K Hoogeveen; Laila Gamadia; E F H van Bommel; P J G van de Ven; Caroline E Douma; H H Vincent; Yvonne C Schrama; Joy Lips; Machiel A Siezenga; Alferso C Abrahams; Marianne C Verhaar; Marije E Hamaker Journal: Nephron Date: 2019-08-13 Impact factor: 2.847
Authors: Clark DuMontier; Mina S Sedrak; Wee Kheng Soo; Cindy Kenis; Grant R Williams; Kristen Haase; Magnus Harneshaug; Hira Mian; Kah Poh Loh; Siri Rostoft; William Dale; Harvey Jay Cohen Journal: J Geriatr Oncol Date: 2019-08-23 Impact factor: 3.599
Authors: Andrew Hantel; Clark DuMontier; Oreofe O Odejide; Marlise R Luskin; Adam S Sperling; Tammy Hshieh; Richard Chen; Robert Soiffer; Jane A Driver; Gregory A Abel Journal: Cancer Date: 2020-11-25 Impact factor: 6.860
Authors: Shakira J Grant; Hira S Mian; Smith Giri; Melina Boutin; Lorenzo Dottorini; Nina R Neuendorff; Jessica L Krok-Schoen; Nikita Nikita; Ashley E Rosko; Tanya M Wildes; Sonja Zweegman Journal: J Geriatr Oncol Date: 2020-12-17 Impact factor: 3.599
Authors: Marie A Flannery; Supriya Mohile; Eva Culakova; Sally Norton; Charles Kamen; J Nicholas Dionne-Odom; Grace DiGiovanni; Lorraine Griggs; Thomas Bradley; Judith O Hopkins; Jane Jijun Liu; Kah Poh Loh Journal: J Pain Symptom Manage Date: 2021-08-08 Impact factor: 3.612