TY - JOUR
T1 - The effect of comprehensive geriatric assessment on care received, treatment completion, toxicity, cancer-related and geriatric assessment outcomes, and quality of life for older adults receiving systemic anti-cancer treatment
T2 - a systematic review
AU - Disalvo, Domenica
AU - Moth, Erin
AU - Soo, Wee Kheng
AU - Garcia, Maja V.
AU - Blinman, Prunella
AU - Steer, Christopher
AU - Amgarth-Duff, Ingrid
AU - Power, Jack
AU - Phillips, Jane
AU - Agar, Meera
PY - 2023/11
Y1 - 2023/11
N2 - Introduction: This systematic review aims to summarise the available literature on the effect of geriatric assessment (multidimensional health assessment across medical, social, and functional domains; “GA”) or comprehensive geriatric assessment (geriatric assessment with intervention or management recommendations; “CGA”) compared to usual care for older adults with cancer on care received, treatment completion, adverse treatment effects, survival and health-related quality of life. Materials and Methods: A systematic search of MEDLINE, EMBASE, CINAHL, and PubMed was conducted to identify randomised controlled trials or prospective cohort comparison studies on the effect of GA/CGA on care received, treatment, and cancer outcomes for older adults with cancer. Results: Ten studies were included: seven randomised controlled trials (RCTs), two phase II randomised pilot studies, and one prospective cohort comparison study. All studies included older adults receiving systemic therapy, mostly chemotherapy, for mixed cancer types (eight studies), colorectal cancer (one study), and non-small cell lung cancer (one study). Integrating GA/CGA into oncological care increased treatment completion (three of nine studies), reduced grade 3+ chemotherapy toxicity (two of five studies), and improved quality of life scores (four of five studies). No studies found significant differences in survival between GA/CGA and usual care. GA/CGA incorporated into care decisions prompted less intensive treatment and greater non-oncological interventions, including supportive care strategies. Discussion: GA/CGA integrated into the care of an older adult with cancer has the potential to optimise care decisions, which may lead to reduced treatment toxicity, increased treatment completion, and improved health-related quality of life scores.
AB - Introduction: This systematic review aims to summarise the available literature on the effect of geriatric assessment (multidimensional health assessment across medical, social, and functional domains; “GA”) or comprehensive geriatric assessment (geriatric assessment with intervention or management recommendations; “CGA”) compared to usual care for older adults with cancer on care received, treatment completion, adverse treatment effects, survival and health-related quality of life. Materials and Methods: A systematic search of MEDLINE, EMBASE, CINAHL, and PubMed was conducted to identify randomised controlled trials or prospective cohort comparison studies on the effect of GA/CGA on care received, treatment, and cancer outcomes for older adults with cancer. Results: Ten studies were included: seven randomised controlled trials (RCTs), two phase II randomised pilot studies, and one prospective cohort comparison study. All studies included older adults receiving systemic therapy, mostly chemotherapy, for mixed cancer types (eight studies), colorectal cancer (one study), and non-small cell lung cancer (one study). Integrating GA/CGA into oncological care increased treatment completion (three of nine studies), reduced grade 3+ chemotherapy toxicity (two of five studies), and improved quality of life scores (four of five studies). No studies found significant differences in survival between GA/CGA and usual care. GA/CGA incorporated into care decisions prompted less intensive treatment and greater non-oncological interventions, including supportive care strategies. Discussion: GA/CGA integrated into the care of an older adult with cancer has the potential to optimise care decisions, which may lead to reduced treatment toxicity, increased treatment completion, and improved health-related quality of life scores.
KW - Comprehensive geriatric assessment
KW - Geriatric oncology
KW - Older adults
KW - Supportive care
KW - Systemic anticancer therapy
KW - Toxicity
UR - http://www.scopus.com/inward/record.url?scp=85168382611&partnerID=8YFLogxK
U2 - 10.1016/j.jgo.2023.101585
DO - 10.1016/j.jgo.2023.101585
M3 - Review article
C2 - 37573197
AN - SCOPUS:85168382611
SN - 1879-4068
VL - 14
SP - 1
EP - 24
JO - Journal of Geriatric Oncology
JF - Journal of Geriatric Oncology
IS - 8
M1 - 101585
ER -