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Journal of Geriatric Oncology

Keyvan Sasani, Helen N Catanese, Alireza Ghods, Seyed Ali Rokni, Hassan Ghasemzadeh, Robert J Downey, Armin Shahrokni
PURPOSE: Gait speed in older patients with cancer is associated with mortality risk. One approach to assess gait speed is with the 'Timed Up and Go' (TUG) test. We utilized machine learning algorithms to automatically predict the results of the TUG tests and its association with survival, using patient-generated responses. METHODS: A decision tree classifier was trained based on functional status data, obtained from preoperative geriatric assessment, and TUG test performance of older patients with cancer...
July 13, 2018: Journal of Geriatric Oncology
Ginah Nightingale, Rowena Schwartz, Ekaterina Kachur, Brianne N Dixon, Christine Cote, Ashley Barlow, Brooke Barlow, Patrick Medina
Unique challenges exist when managing older adults with cancer. Associations between cancer and age-related physiologic changes have a direct impact on pharmacokinetics and pharmacodynamics of cancer therapies and can affect drug dosing, dose intensity, efficacy, safety and quality of life. The breadth and depth of these issues, however, have not been fully evaluated because the majority of clinical trials have focused on a younger and healthier population. As a consequence, little information is available to support clinicians in making evidence-based decisions regarding treatment with cancer therapies in older adults, especially those over age 75...
July 12, 2018: Journal of Geriatric Oncology
Kevin T Nead, Samuel Swisher-McClure
BACKGROUND: Though the optimal treatment regimen in older patients with glioblastoma multiforme (GBM) remains to be established, multiple randomized studies have supported the use of hypofractionated (1-3 weeks) versus traditional regimens (6 weeks). Here we examine hypofractionated regimen practice patterns among older patients with GBM. METHODS: We used the National Cancer Database and included individuals aged ≥65 years with GBM diagnosed from 2005 to 2014 undergoing biopsy/resection followed by chemotherapy and radiation initiated ≤8-weeks of diagnosis...
July 12, 2018: Journal of Geriatric Oncology
Jimmy Ruiz, Antonius A Miller, Janet A Tooze, Sandrine Crane, William J Petty, Ajeet Gajra, Heidi D Klepin
BACKGROUND: Improved assessment strategies are needed to individualize treatment for adults of all ages receiving palliative chemotherapy for non-small cell lung cancer (NSCLC). Our aim was to evaluate the utility of the Fried Frailty Index (FFI) and a cancer-specific geriatric assessment (GA) to predict chemotherapy toxicity and overall survival (OS). METHODS: We conducted a multi-site pilot study of 50 patients with newly diagnosed advanced NSCLC, age ≥ 18 years...
July 10, 2018: Journal of Geriatric Oncology
Enrique Soto-Perez-de-Celis, Kah Poh Loh
No abstract text is available yet for this article.
July 10, 2018: Journal of Geriatric Oncology
Teresa Macarulla, Alfredo Carrato, Rafael Díaz, Adelaida García, Berta Laquente, Javier Sastre, Rafael Álvarez, Andres Muñoz, Manuel Hidalgo
Data regarding management of frail patients with pancreatic ductal adenocarcinoma practice is currently very scarce. Randomized clinical trials usually exclude these subgroup of patients and the majority of the publications only consider chronological age and ECOG performance status for their classification. Therefore, the current available data do not reflect daily clinical practice. Only data from a phase two study (FRAGANCE study), designed to select a tolerable dose-schedule of nab-placitaxel + gemcitabine (Phase oneNCT02382263) and to evaluate the efficacy of the selected regimen (Phase two) in patients with ECOG-2 and previously untreated advanced PDAC, are currently available...
July 10, 2018: Journal of Geriatric Oncology
Maite Antonio, Carlota Gudiol, Cristina Royo-Cebrecos, Sara Grillo, Carmen Ardanuy, Jordi Carratalà
PURPOSE: To assess the etiology, clinical features and outcomes of bacteremia in older patients with solid tumors. METHODS: All episodes of bacteremia in hospitalized patients with solid tumors were prospectively collected. Patients aged ≥70 years were compared to patients aged <70 years. Risk factors for case-fatality rates in older patients were identified. RESULTS: We compared 217 episodes of bacteremia involving older patients and 525 occurring in younger patients...
July 10, 2018: Journal of Geriatric Oncology
Ashley E Rosko, Ying Huang, Don M Benson, Yvonne A Efebera, Craig Hofmeister, Samantha Jaglowski, Steven Devine, Geetika Bhatt, Tanya M Wildes, Alanna Dyko, Desirée Jones, Michelle J Naughton, John C Byrd, Christin E Burd
Multiple myeloma (MM) is a disease of aging adults and autologous stem cell transplant (ASCT) is considered the standard of care. As the population ages a growing number of older adults will undergo ASCT and an objective approach to estimate physiologic reserve and transplant morbidity risk is warranted. Here, we evaluate assess p16INK4a (p16), a molecular aging biomarker, along with geriatric metrics to determine risk of transplant toxicity. METHODS: We prospectively evaluated 100 MM patients for frailty before and after ASCT using a Geriatric Assessment (GA) and collected T-cells for analysis of p16 using a custom nanostring codeset...
July 5, 2018: Journal of Geriatric Oncology
Tyler Raycraft, Winson Y Cheung, Yaling Yin, Caroline Speers, Jenny J Ko, Caroline Mariano
OBJECTIVES: Life expectancy plays a key role in the selection of patients with stage III colon cancer for adjuvant chemotherapy, but little is known about causes of mortality in older patients with colon cancer. We aimed to examine causes of death in this population and compare these causes between patients who received chemotherapy and those who did not. Specifically, we chose to examine the rates of death related to recurrent colon cancer versus non colon cancer. MATERIALS AND METHODS: Patients aged 50 and older diagnosed with stage III colon cancer between 2005 and 2009 were included...
June 27, 2018: Journal of Geriatric Oncology
Leah L Zullig, Gretchen Kimmick, Valerie Smith, Katie Little, Hayden B Bosworth, Sarah Gonzales, Megan M Oakes, Rebecca A Shelby, Lynda Owen, Ivy P Altomare
OBJECTIVE: Geriatric screening tools assess functional limitations and inform clinical decision-making for older adults with cancer. Our objective was to evaluate the feasibility and effectiveness of a screener in community-based oncology clinics. MATERIALS AND METHODS: Eligible patients were from two rural, underserved community-based cancer clinics; within 12 months of a cancer diagnosis (breast, lung, colorectal, pancreas, esophageal); aged ≥60 years; and not exclusively pursuing palliative care...
June 26, 2018: Journal of Geriatric Oncology
Asmus Holmgaard Carlsen, Jesper Grau Eriksen, Christian Godballe, Jørgen Johansen, Jens Ahm Sørensen, Kristine Bjørndal
OBJECTIVES: Fast-track programs for diagnostic work-up and start of cancer treatment are defined by legislation in Denmark. The aim was to examine whether age, comorbidity or WHO performance status influence the time from referral due to suspicion of cancer to start of treatment (waiting time) in the Danish fast-track program. MATERIAL AND METHODS: For this descriptive cohort study, consecutive head and neck cancer (HNC) patients who underwent radiotherapy or surgery from January 2014 to July 2016 at Odense University Hospital (OUH) were identified in the database of the Danish Head and Neck Cancer group (DAHANCA)...
June 25, 2018: Journal of Geriatric Oncology
C J Presley, Ling Han, Linda Leo-Summers, Arti Hurria, Cary P Gross, Amy J Davidoff, Heather G Allore, Thomas M Gill
BACKGROUND: To characterize functional trajectories in the year before and after a new cancer diagnosis among older adults and to identify risk factors for worsening disability post-diagnosis. METHODS: We identified 170 participants 70+ years with monthly assessments of thirteen basic, instrumental, and mobility activities and with a new cancer diagnosis from 1998 to 2014. A group-based trajectory model identified distinct functional trajectories based on a total disability score during the twelve months pre- and post-diagnosis...
June 21, 2018: Journal of Geriatric Oncology
Heather P Lane, SueAnne McLachlan, Jennifer A M Philip
INTRODUCTION: Cancer multidisciplinary meetings (MDMs) are central to treatment decision making. The language used in MDMs may influence treatment decisions, yet has received little research attention. This study aimed to examine the terminology used to describe non-cancer items in the discussion of older people within cancer MDMs. METHODS: MDMs of four tumour streams were attended over twelve weeks. For each person aged 70 or older discussed, the following was hand recorded: age, gender, and phrases describing non-cancer items and patient views...
June 20, 2018: Journal of Geriatric Oncology
Dominic H Moon, Bhishamjit S Chera, Allison M Deal, Yue Wang, Hyman B Muss, Noam A VanderWalde
OBJECTIVES: The agreement between clinician- and patient-reported toxicities and their association with poor tolerance to therapy were assessed in an older population receiving curative radiotherapy (RT). MATERIALS AND METHODS: Patients ≥ 65 years old with newly-diagnosed head and neck or lung cancer receiving curative RT ± chemotherapy were enrolled on a prospective, observational study. Agreement between clinician (CTCAEv4.02) and patient (PRO-CTCAE, EORTC QLQ-C30) report of toxicities were assessed at baseline, during treatment, and post-treatment...
June 11, 2018: Journal of Geriatric Oncology
Muhammad Shahid Iqbal, Divyanshu Dua, Charles Kelly, Paolo Bossi
Managing older patients with head and neck cancers poses a challenge due to the often reduced levels of physiological reserve, the frequent comorbidities and treatment related toxicity. These factors have implications on speech, breathing and swallowing functions. Treatment management plans in these patients may result in de-intensification strategies and as a result of this, use of non-standard treatments is increasing. There have been published reports that indicate the addition of concurrent systemic therapy to radiation in selected older patients is feasible, and produces outcomes comparable with younger patients...
June 9, 2018: Journal of Geriatric Oncology
Elisabeth Castel-Kremer, Solene De Talhouet, Anne-Laure Charlois, Emmanuelle Graillot, Xavier Chopin-Laly, Mustapha Adham, Brigitte Comte, Catherine Lombard-Bohas, Thomas Walter, Gilles Boschetti
INTRODUCTION: Pancreatic adenocarcinoma affects mainly older patients. Surgery is indicated for localized tumors while chemotherapy alone is proposed in advanced or metastatic tumors. OBJECTIVE: To evaluate the feasibility of standard of care oncologic treatments in this population, the accuracy of the geriatric evaluation to predict the ability of patients to tolerate the recommended treatments and to identify specific geriatric prognosis factors. METHODS: We included, between 2007 and 2014, all consecutive patients over 70 years of age with a pathologically diagnosed pancreatic cancer...
June 8, 2018: Journal of Geriatric Oncology
Aung Win Tin, Eleanor Smith, Rebecca Hepworth, Julie Walker, David Wilson, Nick Wadd
INTRODUCTION: Perioperative epirubicin, cisplatin and 5-FU or capecitabine (ECF/X) chemotherapy is recognised as a standard of care for patients with resectable gastroesophageal adenocarcinoma; however, there is limited evidence regarding its use in older patients. The aims of this study were to assess the effectiveness and tolerability of perioperative ECX chemotherapy in patients aged ≥70 years-old (group 1) compared with a younger population (group 2), and to assess differences in the histology of these groups...
June 5, 2018: Journal of Geriatric Oncology
Lisa M Lowenstein, Robert J Volk, Richard Street, Marie Flannery, Allison Magnuson, Ronald Epstein, Supriya G Mohile
OBJECTIVES: Older patients with advanced cancer often have age-related health issues (e.g., memory impairment) that influence their cancer treatment decisions. Communication about these age-related concerns can potentially lead to further assessment and subsequent clinical interventions to improve treatment decision-making and patients' quality of life. Yet, little is known about the communication of age-related concerns between oncologists, patients, and caregivers. MATERIALS AND METHODS: This study is a secondary analysis of data from the Values and Options in Cancer Care (VOICE) study...
June 5, 2018: Journal of Geriatric Oncology
Heide Götze, Norbert Köhler, Sabine Taubenheim, Florian Lordick, Anja Mehnert
OBJECTIVES: Although the median age at cancer diagnosis is about 70 years, few studies have evaluated physical and mental health in older patients. The main objectives of our study are to provide information about depression, functional disabilities and symptom burden in older hematological cancer patients (HCP), compared to a community sample (CS) of older individuals. MATERIALS AND METHODS: We conducted a prospective study with interview assessments at a meantime of 26 month (range 1-60) after diagnosis or relapse of hematologic cancer (ICD: C81 - C96)...
June 4, 2018: Journal of Geriatric Oncology
Deborah S Mack, Mara M Epstein, Catherine Dubé, Robin E Clark, Kate L Lapane
OBJECTIVE: United States (US) guidelines regarding when to stop routine breast cancer screening remain unclear. No national studies to-date have evaluated the use of screening mammography among US long-stay nursing home residents. This cross-sectional study was designed to identify prevalence, predictors, and geographic variation of screening mammography among that population in the context of current US guidelines. MATERIALS AND METHODS: Screening mammography prevalence, identified with Physician/Supplier Part B claims and stratified by guideline age classification (65-74, ≥75 years), was estimated for all women aged ≥65 years residing in US Medicare- and Medicaid- certified nursing homes (≥1 year) with an annual Minimum Data Set (MDS) 3...
June 4, 2018: Journal of Geriatric Oncology
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