C Mariano1, R Jamal2, P Bains3, S Hejazi4, L Chao5, J Wan6, J Ho5. 1. Department of Medicine and Medical Oncology, Royal Columbian Hospital, New Westminster, BC. 2. University of British Columbia, Vancouver, BC. 3. Department of Medicine and Medical Oncology, Lions Gate Hospital, North Vancouver, BC. 4. Department of Evaluation and Research Services, Fraser Health Authority, Surrey, BC. 5. Department of Medicine and Medical Oncology, Lions Gate Hospital, Richmond, BC. 6. Department of Pharmacy, Royal Columbian Hospital, New Westminster, BC.
Abstract
Background: Expert groups have recommended incorporation of a geriatric assessment into clinical practice for older patients starting oncologic therapy. However, that practice is not standard primarily because of resource limitations. In the present study, we evaluated the effect on treatment decisions by oncologists in the community oncology setting of a brief geriatric assessment tool that estimates risk of toxicity. Methods: This prospective longitudinal study in 5 community oncology practices in British Columbia involved patients 70 years of age and older starting a new cytotoxic chemotherapy regimen. Clinical personnel completed a brief validated geriatric assessment tool-the Cancer and Aging Research Group chemotherapy toxicity tool (carg-tt)-that estimates the risk of grade 3 or greater toxicity in older patients. Physicians were asked if the carg-tt changed their treatment plan or prompted extra supports. Patients were followed to assess the incidence of toxicity during treatment. Results: The study enrolled 199 patients between July 2016 and February 2018. Mean age was 77 years. Treatment was palliative in 61.4% of the group. Compared with physician judgment, the carg-tt predicted higher rates of toxicity. In 5 patients, treatment was changed based on the carg-tt. In 38.5% of the patients, data from the tool prompted extra supports. Within the first 3 cycles of treatment, 21.3% of patients had experienced grade 3 or greater toxicity. Conclusions: This study demonstrates that use of a brief geriatric assessment tool is possible in a broad community oncology practice. The tool modified the oncologist's supportive care plan for a significant number of older patients undertaking cytotoxic chemotherapy.
Background: Expert groups have recommended incorporation of a geriatric assessment into clinical practice for older patients starting oncologic therapy. However, that practice is not standard primarily because of resource limitations. In the present study, we evaluated the effect on treatment decisions by oncologists in the community oncology setting of a brief geriatric assessment tool that estimates risk of toxicity. Methods: This prospective longitudinal study in 5 community oncology practices in British Columbia involved patients 70 years of age and older starting a new cytotoxic chemotherapy regimen. Clinical personnel completed a brief validated geriatric assessment tool-the Cancer and Aging Research Group chemotherapy toxicity tool (carg-tt)-that estimates the risk of grade 3 or greater toxicity in older patients. Physicians were asked if the carg-tt changed their treatment plan or prompted extra supports. Patients were followed to assess the incidence of toxicity during treatment. Results: The study enrolled 199 patients between July 2016 and February 2018. Mean age was 77 years. Treatment was palliative in 61.4% of the group. Compared with physician judgment, the carg-tt predicted higher rates of toxicity. In 5 patients, treatment was changed based on the carg-tt. In 38.5% of the patients, data from the tool prompted extra supports. Within the first 3 cycles of treatment, 21.3% of patients had experienced grade 3 or greater toxicity. Conclusions: This study demonstrates that use of a brief geriatric assessment tool is possible in a broad community oncology practice. The tool modified the oncologist's supportive care plan for a significant number of older patients undertaking cytotoxic chemotherapy.
Authors: Martine Extermann; Ivette Boler; Richard R Reich; Gary H Lyman; Richard H Brown; Joseph DeFelice; Richard M Levine; Eric T Lubiner; Pablo Reyes; Frederic J Schreiber; Lodovico Balducci Journal: Cancer Date: 2011-11-09 Impact factor: 6.860
Authors: M T E Puts; B Santos; J Hardt; J Monette; V Girre; E G Atenafu; E Springall; S M H Alibhai Journal: Ann Oncol Date: 2013-11-19 Impact factor: 32.976
Authors: Arti Hurria; Supriya Gupta; Marjorie Zauderer; Enid L Zuckerman; Harvey J Cohen; Hyman Muss; Miriam Rodin; Katherine S Panageas; Jimmie C Holland; Leonard Saltz; Mark G Kris; Ariela Noy; Jorge Gomez; Ann Jakubowski; Clifford Hudis; Alice B Kornblith Journal: Cancer Date: 2005-11-01 Impact factor: 6.860
Authors: Caroline Mariano; Mia Francl; Janice Pope; Linda Wong; Howard J Lim; Caroline Lohrisch Journal: Clin Breast Cancer Date: 2014-09-28 Impact factor: 3.225
Authors: Allison Magnuson; Heather Allore; Harvey Jay Cohen; Supriya G Mohile; Grant R Williams; Andrew Chapman; Martine Extermann; Rebecca L Olin; Valerie Targia; Amy Mackenzie; Holly M Holmes; Arti Hurria Journal: J Geriatr Oncol Date: 2016-07-05 Impact factor: 3.599
Authors: Hyman B Muss; Donald A Berry; Constance Cirrincione; Daniel R Budman; I Craig Henderson; Marc L Citron; Larry Norton; Eric P Winer; Clifford A Hudis Journal: J Clin Oncol Date: 2007-08-20 Impact factor: 44.544
Authors: T Kalsi; G Babic-Illman; P J Ross; N R Maisey; S Hughes; P Fields; F C Martin; Y Wang; D Harari Journal: Br J Cancer Date: 2015-04-14 Impact factor: 7.640
Authors: Darryl Outlaw; Maya Abdallah; Luiz A Gil-Jr; Smith Giri; Tina Hsu; Jessica L Krok-Schoen; Gabor Liposits; Tânia Madureira; Joana Marinho; Ishwaria M Subbiah; Gina Tuch; Grant R Williams Journal: Semin Radiat Oncol Date: 2022-04 Impact factor: 5.934