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The effect of a geriatric evaluation on treatment decisions and outcome for older cancer patients - A systematic review

Hamaker, M. E., te Molder, M., Thielen, N., van Munster, B. C., Schiphorst, A. H. & van Huis, L. H., Sep-2018, In : Journal of Geriatric Oncology. 9, 5, p. 430-440 11 p.

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  • The effect of a geriatric evaluation on treatment decisions

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DOI

Aim: The aim of this systematic review is to summarise all available data on the effect of a geriatric evaluation on the multidisciplinary treatment of older cancer patients, focussing on oncologic treatment decisions, the implementation of non-oncologic interventions and the impact on treatment outcome.

Methods: A systematic search in MEDLINE and EMBASE for studies on the effect of a geriatric evaluation on oncologic and non-oncologic treatment decisions and outcome for older cancer patients.

Results: 36 publications from 35 studies were included. After a geriatric evaluation, the oncologic treatment plan was altered in a median of 28% of patients (range 8-54%), primarily to a less intensive treatment option. Non-oncologic interventions were recommended in a median of 72% of patients (range 26-100%), most commonly involving social issues (39%), nutritional status (32%) and polypharmacy (31%). Effect on treatment outcome was varying, with a trend towards a positive effect on treatment completion (positive effect in 75% of studies) and treatment-related toxicity/complications (55% of studies).

Conclusion: A geriatric evaluation affects oncologic and non-oncologic treatment and appears to improve treatment tolerance and completion for older cancer patients. Fine-tuning the decision-making process for this growing patient population will require more specific and robust data on the effect of a geriatric evaluation on relevant oncologic and non-oncologic outcomes such as survival and quality of life. (C) 2018 Elsevier Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)430-440
Number of pages11
JournalJournal of Geriatric Oncology
Volume9
Issue number5
Publication statusPublished - Sep-2018
Externally publishedYes

    Keywords

  • Geriatric assessment and management, Cancer, Decision making, Non-oncologic interventions, Treatment outcome, ELDERLY-PATIENTS, MAKING PROCESS, MANAGEMENT, IMPACT, INTERVENTIONS, CONSULTATION, FRAILTY, TEAM, FEASIBILITY, ADULTS

ID: 79051255