The increase in life expectancy along with the higher incidence of cancer with age motivates the need for a model of care to optimize the management of elderly patients with cancer and avoid complications associated with treatment. We used two questionnaires: the G8 Oncodage that screens frail elderly patients and the Hurria that predicts the risk of chemotherapy toxicity; both are vulnerability screening tools that help establish the most appropriate treatment in oncogeriatric patients. We present our initial experience with this approach in a single institution in Andorra.
From November, 2017 to April, 2018, the oncology nurse evaluated twenty-six patients with cancer ≥70 years of age. The tools used are short questionnaires (8 items in the G8 and 16 items in the Hurria), clear, simple and quick to perform. They are always used before starting the treatment. Patients with scores G8 > 14 and Hurria < 6 are considered fit for standard oncologic management. Patients with scores G8 ≤ 14 or Hurria ≥ 6 are considered at risk of vulnerability and then an integral geriatric assessment (CGA) is performed. The care plan is established by a multidisciplinary care team.
Twenty-six patients were evaluated, with a majority of males (81%) and the average was 75.9 years (range 70-86 years). A score G8 ≤ 14 or Hurria ≥ 6 occurred in 24 (92.31%) and 22 (84.62%) patients, respectively, 5 were women and 19 men. Two patients with low risk of chemotherapy toxicity (1 woman and 1 man), 15 patients with moderate risk (3 women and 12 men) and 7 at high risk (1 woman and 6 men) were detected. 24 patients were referred to the gerontologist for CGA. Half of patients received a modified treatment.
According to preliminary results, the use of the two questionnaires would allow to select those patients who could benefit from CGA and a personalized treatment. The study proposes a model of nurse-led oncogeriatric screening that could offer objective and useful information in the decision making of the therapeutic plan in elderly patients with cancer. Due to the limited number of patients included, it is necessary to continue the longitudinal and prospective study to draw definitive conclusion.
Clinical trial identification
Legal entity responsible for the study
Servei Andorra Atenció Sanitaria.
Has not received any funding.
All authors have declared no conflicts of interest.