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Serial comprehensive geriatric assessment in elderly head and neck cancer patients undergoing curative radiotherapy identifies evolution of multidimensional health problems and is indicative of quality of life
Author(s) -
Pottel L.,
Lycke M.,
Boterberg T.,
Pottel H.,
Goethals L.,
Duprez F.,
Van Den Noortgate N.,
De Neve W.,
Rottey S.,
Geldhof K.,
Buyse V.,
KargarSamani K.,
Ghekiere V.,
Debruyne P.R.
Publication year - 2014
Publication title -
european journal of cancer care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.849
H-Index - 67
eISSN - 1365-2354
pISSN - 0961-5423
DOI - 10.1111/ecc.12179
Subject(s) - medicine , quality of life (healthcare) , radiation therapy , head and neck cancer , cancer , head and neck , health related quality of life , geriatric oncology , cancer therapy , physical therapy , gerontology , surgery , nursing , disease
Head and neck ( H & N ) cancer is mainly a cancer of the elderly; however, the implementation of comprehensive geriatric assessment ( CGA ) to quantify functional age in these patients has not yet been studied. We evaluated the diagnostic performance of screening tools [ V ulnerable E lders S urvey‐13 ( VES ‐13), G 8 and the C ombined S creening T ool ‘ VES ‐13 + (17‐ G 8)’ or CST ], the feasibility of serial CGA , and correlations with health‐related quality of life evolution [ HRQOL ; E uropean O rganisation for R esearch and T reatment of C ancer Q uality of L ife Q uestionnaires ( EORTC QLQ )‐ C 30 and ‐ HN 35] during therapy in hundred patients, aged ≥65 years, with primary H & N cancer undergoing curative radio(chemo)therapy. Respectively 36.8%, 69.0%, 62.1% and 71.3% were defined vulnerable according to VES ‐13, G 8, CST and CGA at week 0, mostly due to presence of severe grade co‐morbidities, difficulties in community functioning and nutritional problems. At week 4, significantly more patients were identified vulnerable due to nutritional, functional and emotional deterioration. The CST did not achieve the predefined proportion necessary for validation. Vulnerable patients reported lower function and higher symptom HRQOL scores as compared with fit patients. A comparable deterioration in HRQOL was observed in both groups through therapy. In conclusion, G 8 remains the screening tool of choice. Serial CGA identifies the evolution of multidimensional health problems and HRQOL conditions during therapy with potential to guide individualised supportive care.