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Acta Oncol. 2014 Mar;53(3):289-96. doi: 10.3109/0284186X.2013.840741. Epub 2013 Oct 17.

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

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1
Department of Geriatric Medicine, Diakonessenhuis Utrecht , The Netherlands.

Abstract

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 and the implementation of non-oncologic interventions.

METHODS:

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

RESULTS:

Literature search identified 1654 reports (624 from Medline and 1030 from Embase), of which 10 studies were included in the review. Three studies used a geriatric consultation while seven used a geriatric assessment performed by a cancer specialist, healthcare worker or (research) nurse. Six studies addressed a change in oncologic treatment, the initial treatment plan was modified in a median of 39% of patients after geriatric evaluation, of which two thirds resulted in less intensive treatment. Seven studies focused on the implementation of non-oncologic interventions based on the results of the geriatric evaluation; all but one reported that interventions were suggested for over 70% of patients, even in studies that did not focus specifically on frail older patients. In the other study, implementation of non-oncologic interventions was left to the cancer specialist's discretion.

CONCLUSION:

A geriatric evaluation has significant impact on oncologic and non-oncologic treatment decisions in older cancer patients and deserves consideration in the oncologic work-up for these patients.

PMID:
24134505
DOI:
10.3109/0284186X.2013.840741
[Indexed for MEDLINE]
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