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https://www.readbyqxmd.com/read/29381689/geriatric-assessment-may-help-decision-making-in-elderly-patients-with-inoperable-locally-advanced-non-small-cell-lung-cancer
#1
Maite Antonio, Juana Saldaña, Jennifer Linares, José C Ruffinelli, Ramón Palmero, Arturo Navarro, Maria Dolores Arnaiz, Isabel Brao, Samantha Aso, Susana Padrones, Valentí Navarro, Jesús González-Barboteo, Josep Maria Borràs, Felipe Cardenal, Ernest Nadal
BACKGROUND: Although concurrent chemoradiotherapy (cCRT) increases survival in patients with inoperable, locally advanced non-small-cell lung cancer (NSCLC), there is no consensus on the treatment of elderly patients. The aim of this study was to determine the prognostic value of the comprehensive geriatric assessment (CGA) and its ability to predict toxicity in this setting. METHODS: We enrolled 85 consecutive elderly (⩾75 years) participants, who underwent CGA and the Vulnerable Elders Survey (VES-13)...
January 30, 2018: British Journal of Cancer
https://www.readbyqxmd.com/read/29331624/comprehensive-geriatric-assessment-in-the-older-adult-with-cancer-a-review
#2
REVIEW
Catalina Hernandez Torres, Tina Hsu
CONTEXT: The number of older adults with cancer is expected to increase rapidly in the upcoming decades. Aging is heterogeneous and chronological age is often not reflective of biological age. A comprehensive geriatric assessment (CGA) is an in-depth assessment of multiple domains of health that results in better assessment of a patient's overall health and fitness and allows directed intervention to improve patient outcomes. OBJECTIVE: To review the value of CGA for older adults with cancer, CGA composition and tools that can be utilized, and the feasibility of including CGA in oncologic practice...
January 10, 2018: European Urology Focus
https://www.readbyqxmd.com/read/29299751/risk-factors-for-unplanned-discontinuation-of-scheduled-treatment-in-elderly-patients-with-castration-resistant-prostate-cancer-results-of-the-ibutu-study
#3
Friedemann Honecker, Ulrich Wedding, Gerd Kallischnigg, Axel Schroeder, Jörg Klier, Thomas Frangenheim, Lothar Weißbach
PURPOSE: To gain knowledge about the factors associated with discontinuation of scheduled treatment in elderly men with castration-resistant prostate cancer (CRPC). METHODS: Patients ≥ 70 years with CRPC starting a new line of treatment were included in a prospective cohort study. A geriatric assessment (CGA) was performed at baseline, including comorbidity, mobility, functional/mental/nutritional status, as well as depression. Furthermore, pain intensity, quality of life, ECOG-performance status, and physicians' and patients' perception of health were documented...
January 4, 2018: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/29150094/-geriatric-assessment-and-prognostic-scores-in-older-cancer-patient-additional-support-to-the-therapeutic-decision
#4
REVIEW
Frédéric Pamoukdjian, Evelyne Liuu, Philippe Caillet, Mathilde Gisselbrecht, Stéphane Herbaud, Pascaline Boudou-Rouquette, Laurent Zelek, Elena Paillaud
Cancer is a disease of the elderly as demonstrated by the epidemiological evolution of Western countries. Indeed, two third of cancers newly diagnosed occur over 65 years. However, older cancer patients have been often excluded from clinical trials in oncology and the extrapolation of cancer treatments in this population remains difficult in practice. Scientific societies recommend that a comprehensive geriatric assessment (CGA) be performed in patients aged 70 and over and selected using screening tools for frailty such as the G8 index...
November 14, 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/29054805/factors-predicting-adherence-to-a-tailored-dose-adjuvant-treatment-on-the-basis-of-geriatric-assessment-in-elderly-people-with-colorectal-cancer-a-prospective-study
#5
Maite Antonio, Alberto Carmona-Bayonas, Juana Saldaña, Valentí Navarro, Cristian Tebé, Ramon Salazar, Josep Maria Borràs
BACKGROUND: Selecting elderly people with colorectal cancer (CRC) for adjuvant chemotherapy is challenging. Comprehensive geriatric assessment (CGA) can help by classifying them according to their frailty profile. The supposed benefit of chemotherapy is on the basis of the rate of treatment adherence. In this study we evaluated tolerance and adherence to tailored-dose adjuvant therapy on the basis of CGA in a cohort of older patients with high-risk stage II and stage III CRC. PATIENTS AND METHODS: This was a prospective study in 193 consecutive patients aged 75 years or older...
September 28, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/28659138/the-effect-of-geriatric-intervention-in-frail-elderly-patients-receiving-chemotherapy-for-colorectal-cancer-a-randomized-trial-gerico
#6
C M Lund, K K Vistisen, C Dehlendorff, F Rønholt, J S Johansen, D L Nielsen
BACKGROUND: Better surgical techniques, chemotherapy and biological therapy have improved survival in patients with colorectal cancer (CRC), most markedly in younger patients. About half of patients over 70 years receive dose reductions or early treatment discontinuation of the planned adjuvant or first-line treatment due to side effects. The Comprehensive Geriatric Assessment (CGA) is a multidisciplinary evaluation of an elderly individual's health status. This assessment in older patients with cancer can predict survival, chemotherapy toxicity and morbidity...
June 28, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28592379/comprehensive-geriatric-assessment-in-men-aged-70-years-or-older-with-localised-prostate-cancer-undergoing-radical-radiotherapy
#7
G E C Osborne, S A Appleyard, D C Gilbert, C I Jones, C Lorimer, M Villanueva, E Peasgood, A Robinson, A Nikapota, A Ring
AIMS: Treatment decisions for men aged 70 years or over with localised prostate cancer need to take into account the risk of death from competing causes and fitness for the proposed treatment. Objective assessments such as those included in a comprehensive geriatric assessment (CGA) might help to inform the decision-making process. The aim of this study was to describe the CGA scores of a cohort of older men with prostate cancer, evaluate potential screening tools in this population and assess whether any CGA component predicts significant acute radiotherapy toxicity...
September 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28487465/geriatric-assessment-predicts-survival-and-competing-mortality-in-elderly-patients-with-early-colorectal-cancer-can-it-help-in-adjuvant-therapy-decision-making
#8
Maite Antonio, Juana Saldaña, Alberto Carmona-Bayonas, Valentín Navarro, Cristian Tebé, Marga Nadal, Francesc Formiga, Ramon Salazar, Josep Maria Borràs
BACKGROUND: The challenge when selecting elderly patients with colorectal cancer (CRC) for adjuvant therapy is to estimate the likelihood that death from other causes will preclude cancer events from occurring. The aim of this paper is to evaluate whether comprehensive geriatric assessment (CGA) can predict survival and cancer-specific mortality in elderly CRC patients candidates for adjuvant therapy. MATERIAL AND METHODS: One hundred ninety-five consecutive patients aged ≥75 with high-risk stage II and stage III CRC were prospectively included from May 2008 to May 2015...
August 2017: Oncologist
https://www.readbyqxmd.com/read/28479099/protective-effect-of-chlorogenic-acid-against-methotrexate-induced-oxidative-stress-inflammation-and-apoptosis-in-rat-liver-an-experimental-approach
#9
Nemat Ali, Summya Rashid, Sana Nafees, Syed Kazim Hasan, Ayaz Shahid, Ferial Majed, Sarwat Sultana
Methotrexate (MTX) is a drug which is used to treat different types of cancers but hepatotoxicity limits its clinical use. Chlorogenic acid (CGA) is one of the most abundant naturally occurring polyphenols in the human diet. Here, we assessed the effect of CGA against MTX-induced hepatotoxicity and investigated the underlying possible mechanisms in Wistar Rats. Rats were pre-treated with CGA (50 or 100 mg kg/b.w) and administered a single dose of MTX (20 mg/kg, b.w.). MTX caused hepatotoxicity as evidenced by significant increase in serum toxicity markers, histopathological changes...
June 25, 2017: Chemico-biological Interactions
https://www.readbyqxmd.com/read/27630826/treatment-of-elderly-patients-with-squamous-cell-carcinoma-of-the-head-and-neck
#10
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
#11
MULTICENTER STUDY
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
#12
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
#13
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
#14
REVIEW
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
#15
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
#16
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
#17
RANDOMIZED CONTROLLED TRIAL
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
#18
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
#19
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
#20
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
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