Evaluation of tolerance of Temozolomide in different strategies for management of the older person with glioblastoma
Autor: | N. Carré, P. Leglise, B. Bonan, K. Sejean, C. Lepage, E. Perrier-Cornet, E. Dupuydupin, E. Cazal-Bonnel, D. Huchon-Bécel |
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Rok vydání: | 2013 |
Předmět: |
medicine.medical_specialty
Activities of daily living Temozolomide Performance status business.industry Day care Quality of life (healthcare) Oncology Physical therapy Medicine Geriatric Depression Scale Geriatrics and Gerontology business human activities Neurocognitive Depression (differential diagnoses) medicine.drug |
Zdroj: | Journal of Geriatric Oncology. 4:S77 |
ISSN: | 1879-4068 |
DOI: | 10.1016/j.jgo.2013.09.126 |
Popis: | Introduction: The diagnostic value of Comprehensive Geriatric Assessment(CGA) in oncology centres has not yet been established in India. Objectives: To assess whether CGA is feasible,reproducible and comparable in oncology patients in India. Methods: Biopsy proven cancer patients above 65 years,visiting our centres consenting for CGA, not Delirious or suffering from Encephalopathy were included in this analysis.The following components of CGA were assessed: Medical parameters, Nutritional Status, Depression, Neurocognitive functioning, Activities of Daily Living/Instrumental Activities of Daily Living and Quality of Life. A brief self-assembled battery of standardised & culture-fair tests: Mini-mental Status Examination(MMSE), Geriatric Depression Scale(GDS), OARS Activities of Daily Living/Instrumental Activities of Daily Living(ADL/IADL), WHOQuality of Life Scale BREF(WHO-QOL). A trained Psychologist conducted all CGAs with the help of primary oncologist, dietician and occupational therapist.As an exercise, to estimate the feasibility of CGA tools, 1 patient was selected for a detailed CGA(completion time 6 hours). Later, an abbreviated version was developed whereby administration time reduced to 20-30 minutes per CGA and conducted on OPD,IPD and Day Care settings Results: Total N = 46 patients, met our inclusion criteria. Male: Female ratio = 26:20; Age-wise distribution:N65:16,N70-11,N75= 5,N804,N85= 1; Solid Tumors: Lymphoma patients = 38:8. All patients had Performance status of 0,1 7 2(except 1)according to ECOG.18 out of 38 had more than or equal to 2 co-morbidities. Refer the following tables: Interestingly on ADL/IADL scale, Excellent ADL/IADL(n= 11) and Good ADL/IADL(n= 6) whereas mild-moderate impairment in ADL/ IADL(n= 17) and Severely impairment(n= 7), except 1 with complete impairment.On WHO-QOL BREF, on Physical Health Satisfied: Unsatisfied= 11:27; Psychological Health Satisfied:Unsatisfied= 32:6; Social Relationships Satisfied:Unsatisfied= 28:10; Environment Satisfied:Unsatisfied= 27:3 All patients with Severe impairment on any/all areas,had performance status of ≤2 according to oncologist’s review. Conclusion: CGA is a feasible, reproducible procedure involving a multidisciplinary approach. A trained Psychologist is needed as per international standards to administer & interpret psychometric tools used for CGAs.Approx.20% patients had severe impairment in either/ all of the areas, were deemed fit for chemotherapy by the Medical Oncologist. |
Databáze: | OpenAIRE |
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