Significance of the comprehensive geriatric assessment in the administration of chemotherapy to older adults with cancer: Recommendations by the Japanese Geriatric Oncology Guideline Committee |
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| Institution: | 1. Center for Comprehensive Genomic Medicine, Okayama University Hospital, Okayama, Japan;2. Department of Obstetrics and Gynecology, University of Fukui, Fukui, Japan.;3. Department of General Geriatric Medicine, Kawasaki Medical School, Okayama, Japan.;4. Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Aichi, Japan;5. Division of Radiation Oncology, Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan;6. Department of Psychiatry / Palliative Care Center, Nagoya City University West Medical Center, Aichi, Japan;7. National Center for Global Health and Medicine, National College of Nursing, Tokyo, Japan;8. Advanced Cancer Translational Research Institute, Showa University, Tokyo, Japan;9. Department of Frontier Science for Cancer and Chemotherapy, Osaka University Graduate School of Medicine, Osaka, Japan;10. Cancer Solutions Co.,Ltd, Tokyo, Japan;11. Division of Medical Oncology, Department of Medicine, School of Medicine, Teikyo University, Tokyo, Japan;12. NPO Clinical Hematology/Oncology Treatment Study Group, Fukuoka, Japan;13. Breast Oncology Service, Saitama Medical University International Medical Center, Saitama, Japan |
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| Abstract: | IntroductionThe number of older patients with cancer is expected to continue to increase owing to the aging population. Recently, the usefulness of geriatric assessment (GA) conducted by multiple staff members from different medical backgrounds has been reported; however, a consensus on the effectiveness of GA has not yet been achieved.Materials and MethodsWe, as the Japanese Geriatric Oncology Guideline Committee for elderly patients with cancer, conducted a literature search of randomized controlled trials published before August 2021 that used GA or comprehensive GA (CGA) as an intervention for patients with cancer undergoing chemotherapy. As the key outcomes for answering the clinical question, we focused on survival benefit, adverse events, and quality of life (QOL). After a systematic review of these studies, the expert panel member developed recommendations according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system.ResultsFor older patients with cancer, GA or CGA is suggested during or before chemotherapy (weakly recommended). Chemotherapy-induced adverse events were significantly reduced by GA/CGA interventions without any adverse effects on survival. Health-related QOL tended to improve with the GA/CGA interventions.DiscussionAlthough, in our opinion, GA/CGA does require time and resources, it poses no harm patients. Therefore, we suggest expanding the human resources and educating skills of medical providers for clinical implementation of GA/CGA. |
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