Journal of geriatric oncology最新文献

{"title":"Falls in older adults during treatment for metastatic castration-resistant prostate cancer","authors":"Saul Cobbing , Narhari Timilshina , George Tomlinson , Helen Yang , Valerie S. Kim , Urban Emmenegger , Shabbir M.H. Alibhai","doi":"10.1016/j.jgo.2024.102047","DOIUrl":"10.1016/j.jgo.2024.102047","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 1","pages":"Article 102047"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Daily life mobility detects frailty, falls, and functioning in older prostate cancer survivors treated with androgen deprivation therapy","authors":"Deanne C. Tibbitts ,&nbsp;Martina Mancini ,&nbsp;Sydnee Stoyles ,&nbsp;Nathan F. Dieckmann ,&nbsp;Julie N. Graff ,&nbsp;Mahmoud El-Gohary ,&nbsp;Fay B. Horak ,&nbsp;Kerri M. Winters-Stone","doi":"10.1016/j.jgo.2024.102180","DOIUrl":"10.1016/j.jgo.2024.102180","url":null,"abstract":"<div><h3>Introduction</h3><div>Androgen deprivation therapy (ADT) increases the risk of frailty, falls, and poor physical functioning in older adults with prostate cancer. Detection of frailty is limited to self-report instruments and performance measures, so unbiased tools are needed. We investigated relationships between an unbiased measure – daily life mobility – and ADT history, frailty, fall history, and functioning in older prostate cancer survivors treated with ADT.</div></div><div><h3>Materials and Methods</h3><div>This cross-sectional study recruited prostate cancer survivors with a history of ADT from an exercise clinical trial, an academic medical center, and the community. Participants completed performance measures and surveys to assess frailty, fall history, and physical functioning, then wore instrumented socks for up to seven days to continuously monitor daily life mobility. We performed a principal component analysis on daily life mobility metrics and used regression analyses to investigate relationships between domains of daily life mobility and frailty, fall history, and physical functioning.</div></div><div><h3>Results</h3><div>Participants (<em>N</em> = 99) were aged 73.0 +/− 7.3 years, most were pre-frail or frail (75 %), and 35 % had fallen at least once in the last year. Daily life mobility metrics clustered into four domains: Gait Pace, Rhythm, Activity, and Balance. Worse scores on Rhythm and Activity were associated with increased odds of frailty (odds ratio [OR] 1.59, 95 % confidence interval [CI]: 1.04, 2.49 and OR 1.81, 95 % CI: 1.19, 2.83, respectively). A worse score on Rhythm was associated with increased odds of ≥1 falls in the previous year (OR 1.60, 95 % CI: 1.05, 2.47). Worse scores on Gait Pace, Rhythm, and Activity were associated with worse physical functioning. Mobility metrics were similar between current and past users of ADT.</div></div><div><h3>Discussion</h3><div>Continuous passive monitoring of daily life mobility may identify prostate cancer survivors who have developed frailty, falls, and declines in physical functioning.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 2","pages":"Article 102180"},"PeriodicalIF":3.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of p16(INK4a), a biomarker of cellular senescence, with receipt of therapy and frailty status among adults with plasma cell disorders.","authors":"Christopher E Jensen, Allison M Deal, Shweta Srikanth, Kirsten A Nyrop, Natalia Mitin, Matthew R LeBlanc, Hyman B Muss, Samuel M Rubinstein, Sascha A Tuchman, Eben I Lichtman","doi":"10.1016/j.jgo.2024.102174","DOIUrl":"https://doi.org/10.1016/j.jgo.2024.102174","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":" ","pages":"102174"},"PeriodicalIF":3.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic treatment among frail older patients with cancer: An observational cohort","authors":"Solène Doublet ,&nbsp;Arnaud Pagès ,&nbsp;Zoé Ap Thomas ,&nbsp;Geoffroy Beraud-Chaulet ,&nbsp;Marine Valery ,&nbsp;Natacha Naoun ,&nbsp;Florence Canoui-Poitrine ,&nbsp;Céline Nagera-Lazarovici ,&nbsp;Capucine Baldini ,&nbsp;Maxime Frélaut","doi":"10.1016/j.jgo.2024.102177","DOIUrl":"10.1016/j.jgo.2024.102177","url":null,"abstract":"<div><h3>Introduction</h3><div>In the past, certain oncological therapies were not offered to frail older patients. However, the advancement of geriatric oncology, tailored chemotherapy regimens, the introduction of new treatments, and the optimization of supportive care have contributed to enhancing the therapeutic margin. We aimed to evaluate the benefit of systemic treatment among older adults by assessing the three-month survival of older frail patients with metastatic cancer.</div></div><div><h3>Materials and Methods</h3><div>This retrospective cohort study included patients aged 70 and over with metastatic cancer who underwent pre-therapeutic geriatric assessment at Gustave Roussy Hospital between May 2020 and May 2022 and were categorized as “frail” according to the SIOG-1 classification, whether they received systemic treatment (ST group) or exclusive supportive care (SC group).</div></div><div><h3>Results</h3><div>The ST group included 77 patients, and the SC group included 44 patients. Patients in the ST group had a median age of 80.6 years (82.7 years in SC group). The three-month overall survival rate was 81.8 % [95 % Confidence Interval (CI) 71.8; 88.9] in the ST group. The median survival rate was 10.6 months [95 % CI 6.3; 12.6] in the ST group. In multivariate analysis within the ST group, loss of autonomy assessed by activity of daily living (ADL) (HR 2.16 [1.09; 4.28]) and more frailty factors (HR 1.40 [1.01; 1.95]) were associated with lower three-month survival.</div></div><div><h3>Discussion</h3><div>Older frail patients with metastatic cancer may benefit from systemic oncologic treatment. The introduction of such treatment for patients with loss of autonomy in ADL or cumulative frailty factors should be considered only with caution.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 2","pages":"Article 102177"},"PeriodicalIF":3.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The pervasive impact of frailty on ovarian cancer care and the role of prehabilitation: Qualitative perspectives of key stakeholders","authors":"Stephanie Cham ,&nbsp;Rachel A. Pozzar ,&nbsp;Neil Horowitz ,&nbsp;Colleen Feltmate ,&nbsp;Ursula A. Matulonis ,&nbsp;Jennifer C. Lai ,&nbsp;Alexi A. Wright","doi":"10.1016/j.jgo.2024.102173","DOIUrl":"10.1016/j.jgo.2024.102173","url":null,"abstract":"<div><h3>Introduction</h3><div>We performed a qualitative study to explore key stakeholders' perspectives about the impact of frailty on ovarian cancer care and evaluate a candidate prehabilitation intervention.</div></div><div><h3>Materials and Methods</h3><div>We conducted semi-structured interviews with patient-caregiver dyads and multi-disciplinary clinicians. Patients were ≥ 50 years of age with a new diagnosis of advanced stage (III/IV) ovarian cancer who received cancer-directed treatment (chemotherapy and/or surgery) during the past year and met criteria as pre-frail or frail using the FRAIL scale. We used a semi-structured interview guide to elicit participants' views on frailty, nutrition, physical therapy, and a candidate prehabilitation intervention. We used inductive and deductive approaches to code and analyze interviews and identify emergent themes and patterns.</div></div><div><h3>Results</h3><div>Ten patients and caregivers (five dyads) and 10 providers were interviewed. We identified four themes: (1) frailty screening is essential to prevent over- and under-treatment, but underused; (2) stakeholders preferred a multidisciplinary approach to providing tailored care for frail patients over a candidate prehabilitation intervention; (3) patient, family caregiver, and clinician stakeholders reported multiple barriers to prehabilitation programs, including concerns about selection bias, and (4) frail patients and family members are vulnerable and require more psychosocial support.</div></div><div><h3>Discussion</h3><div>We identified significant barriers to prehabilitation interventions for frail patients with ovarian cancer; initiatives to increase frailty screening and provide tailored multi-disciplinary approaches may have a greater impact.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 2","pages":"Article 102173"},"PeriodicalIF":3.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing educational gaps in geriatric oncology: Insights from medical oncologists","authors":"Kian Godhwani,&nbsp;Shabbir M.H. Alibhai,&nbsp;Alana Miller,&nbsp;Guillaume Lim Fat","doi":"10.1016/j.jgo.2024.102162","DOIUrl":"10.1016/j.jgo.2024.102162","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 3","pages":"Article 102162"},"PeriodicalIF":3.0,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computed tomography-determined high visceral adipose tissue and sarcopenic obesity and their associations with survival in vulnerable or frail older adults with cancer considered for systemic anticancer treatment","authors":"Antti Tolonen ,&nbsp;Kaisa Lehtomäki ,&nbsp;Hanna Kerminen ,&nbsp;Heini Huhtala ,&nbsp;Maarit Bärlund ,&nbsp;Pia Österlund ,&nbsp;Otso Arponen","doi":"10.1016/j.jgo.2024.102171","DOIUrl":"10.1016/j.jgo.2024.102171","url":null,"abstract":"<div><h3>Introduction</h3><div>Treatment decisions are challenging in older adults with solid tumors. Geriatric 8 (G8)-screening and comprehensive geriatric assessment (CGA) are important but additional methods are needed. We examined the association of computed tomography (CT)-derived high visceral adipose tissue index (VATI) with or without low skeletal muscle index (SMI) on three-month and overall survival (OS).</div></div><div><h3>Materials and Methods</h3><div>Vulnerability was evaluated with G8 in patients ≥75 years referred for systemic anticancer treatment. Vulnerable/frail patients (G8 ≤ 14) received CGA and were included. VATI and SMI were retrospectively measured from CT scans. We examined associations between high VATI with or without low SMI and three-month and OS with Cox regression models and Kaplan-Meier estimation.</div></div><div><h3>Results</h3><div>Seventy-nine patients with median age of 80 (range 75–91) years were evaluated. In the palliative-intent group (<em>n</em> = 58), three-month OS rates were 88 % and 58 % in the normal and high VATI groups, respectively (hazard ratio 4.3; 95 % confidence interval 1.3–14), and 88 % vs. 47 % in group without and with ‘high VATI+low SMI’, respectively (5.5; 1.9–17). The median OS was 12.7 vs. 9.5 months in normal VATI/SMI and ‘high VATI+low SMI’ (1.9; 1.1–3.2), respectively. In Cox multivariable models with established predictive factors (ECOG PS, Clinical Frailty Scale, and sex), only high VATI (4.9; 1.0–24) or ‘high VATI+low SMI’ (8.9; 1.7–46) remained significant predictors of three-month OS.</div></div><div><h3>Discussion</h3><div>High VATI with or without low SMI were associated with impaired three-month OS in the palliative-intent group and with OS in the whole cohort independently of oncologic and geriatric functional status measures; thus, they may aid in treatment decision-making.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 2","pages":"Article 102171"},"PeriodicalIF":3.0,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of the Taiwan Cancer Frailty Tool for older patients with cancer: A prospective longitudinal study","authors":"Yu-Shin Hung ,&nbsp;Kun-Yun Yeh ,&nbsp;Shun-Wen Hsueh ,&nbsp;Chang-Hsien Lu ,&nbsp;Wen-Chi Chou","doi":"10.1016/j.jgo.2024.102170","DOIUrl":"10.1016/j.jgo.2024.102170","url":null,"abstract":"<div><h3>Introduction</h3><div>The increasing occurrence of cancer in Taiwan's older population highlights the need for a culturally attuned frailty assessment tool. This study aimed to develop and validate a frailty screening instrument specifically designed for older Taiwanese patients with cancer to predict survival outcomes.</div></div><div><h3>Materials and Methods</h3><div>Patients aged ≥65 years newly diagnosed with cancer before treatment initiation at three Hospitals in Taiwan were prospectively included from July 2018 to December 2020 to participate in the study. Participants were randomly divided into development and validation groups with a 3:1 ratio. Key variables from the comprehensive geriatric assessment (CGA) were selected to create the Taiwan Cancer Frailty Tool (TCFT). The ability of the TCFT to evaluate frailty and predict survival outcomes was tested.</div></div><div><h3>Results</h3><div>Overall, 692 patients were included over the recruitment period, with 519 and 173 in the development and validation cohorts, respectively. The TCFT was developed based on five multivariate analysis factors from the CGA (weight loss, restricted mobility/transfer, falls, impaired cognitive function, and polypharmacy), scoring each factor binary with a maximum score of five. The areas under the receiver operating characteristic curve for the TCFT in predicting frailty were 0.79 (95 % confidence interval [CI]: 0.75–0.83) and 0.86 (95 % CI: 0.80–0.91) in the development and validation groups, respectively, compared with the CGA as the gold standard. Higher TCFT scores correlated with shorter survival (hazard ratio [HR]: 2.39–6.99 and 10.2–88.3) in the development and validation groups, respectively, (<em>p</em> &lt; 0.001).</div></div><div><h3>Discussion</h3><div>Our study suggests that the TCFT effectively predicts frailty and survival among older Taiwanese patients with cancer, proving to be a culturally sensitive screening tool. Future studies should target a wider application and validation across diverse clinical settings.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 2","pages":"Article 102170"},"PeriodicalIF":3.0,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioids and benzodiazepines in oncology: Perspectives on coprescribing and mitigating risks","authors":"Amy O'Regan ,&nbsp;Jeehye Rose Lee ,&nbsp;Cara L. McDermott ,&nbsp;Harvey Jay Cohen ,&nbsp;Jessica S. Merlin ,&nbsp;Andrea Des Marais ,&nbsp;Aaron N. Winn ,&nbsp;Salimah H. Meghani ,&nbsp;Devon K. Check","doi":"10.1016/j.jgo.2024.102172","DOIUrl":"10.1016/j.jgo.2024.102172","url":null,"abstract":"<div><h3>Introduction</h3><div>Opioids and benzodiazepines are commonly prescribed for cancer symptoms. In combination, they can increase the risk of adverse events, particularly for older adults with multimorbidity, who represent most patients with cancer. We aimed to understand cancer care providers' practices for opioid and benzodiazepine coprescribing and mitigating potential harms.</div></div><div><h3>Materials and Methods</h3><div>We interviewed oncology and palliative care providers from two health systems. Interviews focused on attitudes about and current practices for coprescribing opioids and benzodiazepines. We analyzed interview transcripts using a staged approach to thematic analysis.</div></div><div><h3>Results</h3><div>Twenty providers (10 oncology, 10 palliative care) participated. We identified three key themes. (1) Reluctance to prescribe benzodiazepines: providers reported rarely coprescribing because they do not routinely prescribe benzodiazepines, which were viewed as having a poor safety profile. (2) Medication safety precautions: these included starting at a low dose and titrating up slowly, consolidating prescriptions under one provider whenever possible, and providing patient and caregiver education around side effects, overdose, and naloxone. Compared to oncologists, palliative care providers more often described providing naloxone to patients and caregivers. (3) Risk assessment and monitoring: most providers mentioned checking state Prescription Drug Monitoring Program databases and conducting chart reviews to identify evidence of substance misuse history. Several oncologists expressed discomfort in asking about substance misuse history due to concerns about stigma. Providers described sometimes relying on their perception of a patient's trustworthiness, with some acknowledging the potential for bias.</div></div><div><h3>Discussion</h3><div>We highlight opportunities to improve medication review and reconciliation practices in oncology, increase uptake of naloxone in oncology practice, systematize efforts to screen patients for substance misuse, and strengthen integration of addiction and psychiatry services into oncology and palliative care settings. Regular use of geriatric assessment in oncology would also address many of the safety concerns we observed.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 2","pages":"Article 102172"},"PeriodicalIF":3.0,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impressions from a Belgian medical oncologist visiting two world-class geriatric oncology clinics in Canada and the United States","authors":"Hans Wildiers","doi":"10.1016/j.jgo.2024.102179","DOIUrl":"10.1016/j.jgo.2024.102179","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 2","pages":"Article 102179"},"PeriodicalIF":3.0,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}