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https://www.readbyqxmd.com/read/27630826/treatment-of-elderly-patients-with-squamous-cell-carcinoma-of-the-head-and-neck
#1
REVIEW
Petr Szturz, Jan B Vermorken
The demographics of squamous cell carcinoma of the head and neck (SCCHN) is marked by a growing number of patients aged 65 and over, which is in line with global projections for other cancer types. In developed countries, more than half of new SCCHN cases are diagnosed in older people, and in 15 years from now, the proportion is expected to rise by more than 10%. Still, a high-level evidence-based consensus to guide the clinical decision process is strikingly lacking. The available data from retrospective studies and subset analyses of prospective trials suffer from a considerable underrepresentation of senior participants...
2016: Frontiers in Oncology
https://www.readbyqxmd.com/read/27579728/predictive-comprehensive-geriatric-assessment-in-elderly-prostate-cancer-patients-the-prospective-observational-scoop-trial-results
#2
Chiara Della Pepa, Carla Cavaliere, Sabrina Rossetti, Marilena Di Napoli, Sabrina C Cecere, Anna Crispo, Carlo De Sangro, Emanuela Rossi, Dino Turitto, Domenico Germano, Gelsomina Iovane, Massimiliano Berretta, Carmine D'Aniello, Salvatore Pisconti, Luigi Maiorino, Bruno Daniele, Cesare Gridelli, Sandro Pignata, Gaetano Facchini
The Comprehensive Geriatric Assessment (CGA) represents the future of the geriatric oncology to reduce toxicities and treatment-related hospitalization in the elderly. Most patients receiving docetaxel for metastatic castration-resistant prostate cancer are in their seventies or older. We explored the efficacy of the CGA in predicting chemotherapy feasibility and response to docetaxel in a cohort of 24 patients aged at least 70. This was an observational, prospective study involving 24 patients who were 70 years of age or older and about to start chemotherapy with docetaxel for metastatic castration-resistant prostate cancer; we performed a CGA including five domains and divided our patients into 'healthy' and 'frail'; the relations between general condition and (i) early chemotherapy discontinuation and (ii) response to docetaxel were explored...
January 2017: Anti-cancer Drugs
https://www.readbyqxmd.com/read/27529755/frailty-as-determined-by-a-comprehensive-geriatric-assessment-derived-deficit-accumulation-index-in-older-patients-with-cancer-who-receive-chemotherapy
#3
Harvey Jay Cohen, David Smith, Can-Lan Sun, William Tew, Supriya G Mohile, Cynthia Owusu, Heidi D Klepin, Cary P Gross, Stuart M Lichtman, Ajeet Gajra, Julie Filo, Vani Katheria, Arti Hurria
BACKGROUND: Frailty has been suggested as a construct for oncologists to consider in treating older cancer patients. Therefore, the authors assessed the potential of creating a deficit-accumulation frailty index (DAFI) from a largely self-administered comprehensive geriatric assessment (CGA). METHODS: Five hundred patients aged ≥65 years underwent a CGA before receiving chemotherapy. A DAFI was constructed, resulting in a 51-item scale, and cutoff values were examined for patients in the robust/nonfrail (cutoff value, 0...
December 15, 2016: Cancer
https://www.readbyqxmd.com/read/27267093/practice-pearls-in-the-management-of-lung-cancer-in-the-elderly
#4
REVIEW
Ravindran Kanesvaran, Anupama Roy Chowdhury, Lalit Krishna
Lung cancer is a disease that afflicts the elderly. It is a leading cause of cancer mortality worldwide. Treatment of lung cancer which was predominantly combination chemotherapy was initially thought to be too toxic for older patients with cancer due to their frail state. However a number of recent studies have shown that this is not necessarily true and many elderly can actually tolerate combination chemotherapy and derive just as much benefit from it as younger patients with lung cancer do. More recently it has been found that a significant proportion of lung cancer patients have tumors that harbor mutations that are targetable by molecularly targeted therapy (MTT)...
September 2016: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/27010772/adjuvant-chemotherapy-in-elderly-patients-with-breast-cancer-key-challenges
#5
Noam Pondé, Lissandra Dal Lago, Hatem A Azim
Elderly women with early breast cancer (BC) form a heterogeneous and large subgroup (41.8% of women with BC are over 65). Decision making in this subgroup is made more difficult by lack of familiarity with their physical, cognitive and social issues. Adequate management depends on biological factors and accurate clinical evaluation through comprehensive geriatric assessment (CGA). CGA can help to better select and determine potential risks factors for patients who are candidates for adjuvant chemotherapy. It is still recently introduced in geriatric oncology and there is a lack of awareness of its importance...
June 2016: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/26997159/-comprehensive-geriatric-assessment-cga-in-elderly-with-cancer-for-whom
#6
E Liuu, P Caillet, H Curé, N Anfasi, L De Decker, F Pamoukdjian, F Canouï-Poitrine, P Soubeyran, E Paillaud
Scientific societies recommend the implementation of a comprehensive geriatric assessment (CGA) in cancer patients aged 70 and older. The EGA is an interdisciplinary multidimensional diagnostic process seeking to assess the frail older person in order to develop a coordinated plan of treatment and long-term follow-up. Identification of comorbidities and age-induced physiological changes that may increase the risk of anticancer treatment toxicities is essential to better assess the risk-benefit ratio in elderly cancer patients...
July 2016: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/26912977/metastatic-neuroendocrine-tumor-with-extensive-bone-marrow-involvement-at-diagnosis-evaluation-of-response-and-hematological-toxicity-profile-of-prrt-with-177-lu-dotatate
#7
Sandip Basu, Rohit Ranade, Pradeep Thapa
The aim of this study was to evaluate the response and hematological toxicity in peptide receptor radionuclide therapy (PRRT) with lutetium ((177)Lu)-DOTA-octreotate (DOTATATE) in metastatic neuroendocrine tumor (NET) with extensive bone marrow metastasis at the initial diagnosis. A retrospective evaluation was undertaken for this purpose: Patients with NET with extensive diffuse bone marrow involvement at diagnosis who had received at least three cycles of PRRT with (177)Lu-DOTATATE were considered for the analysis...
January 2016: World Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/26884557/use-of-a-comprehensive-geriatric-assessment-for-the-management-of-elderly-patients-with-advanced-non-small-cell-lung-cancer-the-phase-iii-randomized-esogia-gfpc-gecp-08-02-study
#8
Romain Corre, Laurent Greillier, Hervé Le Caër, Clarisse Audigier-Valette, Nathalie Baize, Henri Bérard, Lionel Falchero, Isabelle Monnet, Eric Dansin, Alain Vergnenègre, Marie Marcq, Chantal Decroisette, Jean-Bernard Auliac, Suzanna Bota, Régine Lamy, Bartomeu Massuti, Cécile Dujon, Maurice Pérol, Jean-Pierre Daurès, Renaud Descourt, Hervé Léna, Carine Plassot, Christos Chouaïd
PURPOSE: Comprehensive geriatric assessment (CGA) is recommended to assess the vulnerability of elderly patients, but its integration in cancer treatment decision making has never been prospectively evaluated. Here, in elderly patients with advanced non-small-cell lung cancer (NSCLC), we compared a standard strategy of chemotherapy allocation on the basis of performance status (PS) and age with an experimental strategy on the basis of CGA. PATIENTS AND METHODS: In a multicenter, open-label, phase III trial, elderly patients ≥ 70 years old with a PS of 0 to 2 and stage IV NSCLC were randomly assigned between chemotherapy allocation on the basis of PS and age (standard arm: carboplatin-based doublet if PS ≤ 1 and age ≤ 75 years; docetaxel if PS = 2 or age > 75 years) and treatment allocation on the basis of CGA (CGA arm: carboplatin-based doublet for fit patients, docetaxel for vulnerable patients, and best supportive care for frail patients)...
May 1, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/26722364/chemotherapy-in-elderly-patients-with-gastric-cancer
#9
REVIEW
Hyeong Su Kim, Jung Han Kim, Ji Won Kim, Byung Chun Kim
Gastric cancer (GC) is one of the most frequent malignant diseases in the elderly. Systemic chemotherapy showed an improvement of quality of life and survival benefit compared to supportive care alone in patients with advanced GC. Because comorbidities or age-related changes in pharmacokinetics and pharmacodynamics may lead to higher toxicity, however, many oncologists hesitate to recommend elderly patients to receive chemotherapy. Available data suggest that elderly patients with GC are able to tolerate and benefit from systemic chemotherapy to the same extent as younger patients...
2016: Journal of Cancer
https://www.readbyqxmd.com/read/26088748/estimating-the-risk-of-chemotherapy-toxicity-in-older-patients-with-cancer-the-role-of-the-vulnerable-elders-survey-13-ves-13
#10
Andrea Luciani, Laura Biganzoli, Giuseppe Colloca, Cristina Falci, Bruno Castagneto, Irene Floriani, Nicolò Battisti, Lorenzo Dottorini, Daris Ferrari, Pasquale Fiduccia, Elena Zafarana, Francesca Del Monte, Francesca Galli, Silvio Monfardini, Paolo Foa
OBJECTIVE: Some parameters of the Comprehensive Geriatric Assessment (CGA) are predictive of chemotherapy toxicity. The Vulnerable Elders Survey-13 (VES-13) is a short instrument that has been tested as a means of identifying patients who need a full CGA, but its ability to predict chemotherapy toxicity is still unclear. We performed a pooled analysis of four published clinical trials studying VES-13 as a means of diagnosing vulnerability, in order to evaluate its accuracy in predicting the risk of grade 3/4 toxicity in older patients undergoing chemotherapy...
July 2015: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/25871332/the-impact-of-comprehensive-geriatric-assessment-interventions-on-tolerance-to-chemotherapy-in-older-people
#11
T Kalsi, G Babic-Illman, P J Ross, N R Maisey, S Hughes, P Fields, F C Martin, Y Wang, D Harari
BACKGROUND: Although comorbidities are identified in routine oncology practice, intervention plans for the coexisting needs of older people receiving chemotherapy are rarely made. This study evaluates the impact of geriatrician-delivered comprehensive geriatric assessment (CGA) interventions on chemotherapy toxicity and tolerance for older people with cancer. METHODS: Comparative study of two cohorts of older patients (aged 70+ years) undergoing chemotherapy in a London Hospital...
April 28, 2015: British Journal of Cancer
https://www.readbyqxmd.com/read/25621776/-cancer-treatment-in-elderly-patients-evidence-and-clinical-research
#12
Lazzaro Repetto, Andrea Luciani
In 2020 the percentage of patients with a diagnosis of cancer in people with more than 65 years will exceed 70% and 28% in ethnic minorities. The treatment of cancer in these populations is challenging for the oncologists due to socio-economic issues such as poverty, reduced access to the hospital care, level of education. The clinical pathway "diagnosis-treatment-cure", typical of the care of young patients has to be integrated in elderly patients with a more individualized treatment by means of comprehensive geriatric assessment (CGA)...
January 2015: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/25592175/predicting-fatigue-in-older-breast-cancer-patients-receiving-radiotherapy-a-head-to-head-comparison-of-established-assessments
#13
COMPARATIVE STUDY
Michael Dieter Denkinger, Melanie Hasch, Anna Gerstmayer, Rolf Kreienberg, Thorsten Nikolaus, Katharina Hancke
OBJECTIVES: Because of substantial toxicities in older adults, chemotherapy is often omitted while the frequency of radiotherapy changes only minimally. In this study, we addressed the value of different assessments for predicting fatigue after radiotherapy in older breast cancer patients. PATIENTS AND METHODS: We included 74 women with primary breast cancer over the age of 65 years treated with radiotherapy (26 % with additional chemotherapy). Assessments were conducted before adjuvant treatment and after radiotherapy...
February 2015: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/25076233/somatostatin-analogs-and-disease-control-in-castration-resistant-prostate-cancer-different-biological-behavior-case-series-and-review-of-the-literature
#14
Rolando Maria D'Angelillo, Carlo Greco, Michele Fiore, Edy Ippolito, Luca Eolo Trodella, Aurelia Iurato, Elisabetta Molfese, Sara Ramella, Lucio Trodella
AIMS AND BACKGROUND: Castration-resistant prostate cancer is a recent biological behavior where disease can elude androgen deprivation therapy (ADT). Several pathways have been described, including neuroendocrine dedifferentiation. Patients with neuroendocrine dedifferentiation show an increase in chromogranin A (CgA) along with a PSA increase. Our aim was to evaluate the response of patients with castration-resistant prostate cancer and high CgA serum levels after treatment with inhibitors of neuroendocrine cells (somatostatin analogs) in combination with ADT...
May 2014: Tumori
https://www.readbyqxmd.com/read/25060421/a-review-of-the-management-of-elderly-patients-with-non-small-cell-lung-cancer
#15
REVIEW
R Blanco, I Maestu, M G de la Torre, A Cassinello, I Nuñez
Most patients with non-small-cell lung cancer (NSCLC) are elderly but evidence to guide appropriate treatment decisions for this age group is generally scant. Careful evaluation of the elderly should be undertaken to ensure that treatment appropriate for the stage of the tumour is guided by patient characteristics and not by age. The Comprehensive Geriatric Assessment (CGA) remains the preferred option, but briefer tools may be appropriate to select patients for further evaluation. The predicted outcome should be used to guide management decisions together with a reappraisal of polypharmacy...
March 2015: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/24923533/impact-of-comprehensive-geriatric-assessment-on-survival-function-and-nutritional-status-in-elderly-patients-with-head-and-neck-cancer-protocol-for-a-multicentre-randomised-controlled-trial-egesor
#16
RANDOMIZED CONTROLLED TRIAL
Lydia Brugel, Marie Laurent, Philippe Caillet, Anne Radenne, Isabelle Durand-Zaleski, Michel Martin, Melany Baron, Héloïse de Kermadec, Sylvie Bastuji-Garin, Florence Canouï-Poitrine, Elena Paillaud
BACKGROUND: Survival is poorer in elderly patients with head and neck squamous cell carcinomas [HNSCCs] than in younger patients. Possible explanations include a contribution of co-morbidities to mortality, frequent refusal of standard therapy, and the use of suboptimal treatments due to concern about toxicities. The Comprehensive Geriatric Assessment [CGA] is a multidimensional assessment of general health that can help to customise treatment and follow-up plans. The CGA has been proven effective in several health settings but has not been evaluated in randomised studies of patients with cancer...
June 13, 2014: BMC Cancer
https://www.readbyqxmd.com/read/24495700/geriatric-screening-results-and-the-association-with-severe-treatment-toxicity-after-the-first-cycle-of-radio-chemotherapy
#17
Abdelbari Baitar, Frank Van Fraeyenhove, An Vandebroek, Els De Droogh, Daniella Galdermans, Jeroen Mebis, Dirk Schrijvers
BACKGROUND: Screening tools are used in geriatric oncology to determine who should receive a Comprehensive Geriatric Assessment (CGA). However, in this prospective study, we evaluated the association between geriatric screening results, measured with the G8 and Groningen Frailty Indicator (GFI), and severe treatment toxicity. METHODS: Patients over 65 years with various types and stages of cancer were screened with the G8 and the GFI prior to the start of treatment...
April 2014: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/24451757/considerations-and-controversies-in-the-management-of-older-patients-with-advanced-cancer
#18
Supriya Gupta Mohile, Heidi D Klepin, Arati V Rao
The incidence of cancer increases with age. Oncologists need to be adept at assessing physiologic and functional capacity in older patients in order to provide safe and efficacious cancer treatment. Assessment of underlying health status is especially important for older patients with advanced cancer, for whom the benefits of treatment may be low and the toxicity of treatment high. The comprehensive geriatric assessment (CGA) is the criterion standard for evaluation of the older patient. The combined data from the CGA can be used to stratify patients into categories to better predict risk for chemotherapy toxicity as well as overall outcomes...
2012: American Society of Clinical Oncology Educational Book
https://www.readbyqxmd.com/read/24314824/baseline-comprehensive-geriatric-assessment-is-associated-with-toxicity-and-survival-in-elderly-metastatic-breast-cancer-patients-receiving-single-agent-chemotherapy-results-from-the-omega-study-of-the-dutch-breast-cancer-trialists-group
#19
RANDOMIZED CONTROLLED TRIAL
M E Hamaker, C Seynaeve, A N M Wymenga, H van Tinteren, J W R Nortier, E Maartense, H de Graaf, F E de Jongh, J J Braun, M Los, J G Schrama, A E van Leeuwen-Stok, S M de Groot, C H Smorenburg
AIM: To evaluate the association between baseline comprehensive geriatric assessment (CGA) or the Groningen Frailty Indicator (GFI) and toxicity in elderly metastatic breast cancer (MBC) patients treated with first-line palliative chemotherapy. PATIENTS AND METHODS: MBC patients (≥65 years) were randomized between pegylated liposomal doxorubicine or capecitabine. CGA included instrumental activities of daily living (IADL), cognition using the mini-mental state examination (MMSE), mood using the geriatric depression scale (GDS), comorbidity using the Charlson index, polypharmacy and nutritional status using the body mass index...
February 2014: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/24168150/treatment-approaches-in-elderly-patients-with-head-and-neck-cancer
#20
REVIEW
Francesco Perri, Franco Ionna, Ettore Pavone, Francesco Longo, Francesco Caponigro
Integration of geriatric assessment into cancer clinical practice is strongly needed in squamous cell carcinoma of the head and neck (SCCHN) due to the frequent discrepancy between chronologic and biologic age. Comprehensive Geriatric Assessment (CGA) is a multidimensional assessment tool that examines age-related domains. These parameters can be well assessed by easier tests such as Activity Daily Living and Instrumental Activity Daily Living for functional status; Charlson Comorbidity Index for comorbidity; Mini Mental State examination for cognitive status; Mini Nutritional Assessment for nutritional status; Beers criteria for concomitant drug assumption...
November 2013: Anti-cancer Agents in Medicinal Chemistry
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