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1.
Eur J Clin Invest ; 51(1): e13347, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32648990

RESUMO

INTRODUCTION: Optimizing the approach to older adults with cancer is now a priority given the increasing frequency of new cancer diagnoses that are made in the older population. The comprehensive geriatric assessment (CGA) represents the gold-standard for (1) defining prognosis and ability to withstand cancer treatments, (2) exploring the multiple aspects that define the complexity of frail older persons, and (3) designing person-tailored interventions. MATERIALS AND METHODS: In this document, based on a comprehensive revision of the literature, the Italian Society for Geriatrics and Gerontology proposes a CGA model (ONCOGER CGA) to be adopted by oncology centers for their routine approach to older patients with cancer. RESULTS AND DISCUSSION: A widespread use of this standardized CGA format will facilitate comparisons across institutions, promote studies based on a multidimensional patient assessment, and foster the inclusion of geriatric endpoints in oncological clinical trials. Furthermore, we predict that the use of a standardized CGA approach will increase the integration of geriatricians into oncology care teams with the final result of improving therapeutic choices and clinical outcomes.


Assuntos
Avaliação Geriátrica/métodos , Neoplasias , Idoso , Idoso de 80 Anos ou mais , Cognição , Técnica Delphi , Depressão , Estado Funcional , Geriatria , Humanos , Itália , Multimorbidade , Estado Nutricional , Desempenho Físico Funcional , Polimedicação , Qualidade de Vida , Sarcopenia , Sociedades Médicas , Fatores Socioeconômicos
2.
Tumori ; 107(1): 26-31, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32410505

RESUMO

BACKGROUND: Elderly patients are often excluded from advanced treatments owing to clinical complexity or frailty. Magnetic resonance-guided radiotherapy (MRgRT) represents a new frontier of radiotherapy delivery that can play an important role in the management of these patients. AIM: To assess MRgRT feasibility in elderly patients, describe their compliance with this treatment, and provide a scoring system for elderly patient selection. METHODS: Patients aged >75 years were enrolled. No restrictions on tumor site, staging, or treatment intent were applied. Patients underwent joint radiation oncology-geriatrics visits to assess the feasibility of MRgRT and to identify the most significant items (i.e. clinical variables) for the setup of a scoring system. The proposed scoring system was then internally validated on a prospectively enrolled cohort of elderly patients who were candidates for MRgRT. RESULTS: Thirty patients were enrolled between February and March 2018. Their mean age was 81.4 ± 3.4 years (range 75-88). Radiotherapy intent was curative in 26 patients; 14 patients were considered frail at screening tests before radiotherapy. Twelve items were identified as clinically significant for the setup of the MASTER score (MRI-Guided Radiotherapy Selection Elderly Score) score. Validation of the score showed 100% reliability, with no patient discharged after selection. CONCLUSIONS: MRgRT appears to be feasible in elderly patients and the MASTER score is proposed to support clinical decision-making in recommending elderly patients for this technology.


Assuntos
Imageamento por Ressonância Magnética/métodos , Neoplasias/radioterapia , Radioterapia Guiada por Imagem/métodos , Idoso , Idoso de 80 Anos ou mais , Estudos de Viabilidade , Feminino , Humanos , Masculino , Neoplasias/diagnóstico por imagem , Neoplasias/patologia , Radiocirurgia/métodos , Dosagem Radioterapêutica/normas , Planejamento da Radioterapia Assistida por Computador/métodos
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