PMID- 32593669
OWN - NLM
STAT- MEDLINE
DCOM- 20210728
LR  - 20210728
IS  - 1879-4076 (Electronic)
IS  - 1879-4068 (Linking)
VI  - 12
IP  - 1
DP  - 2021 Jan
TI  - Impact of stereotactic body radiation therapy on geriatric assessment and 
      management for older patients with head and neck cancer using G8.
PG  - 122-127
LID - S1879-4068(20)30176-4 [pii]
LID - 10.1016/j.jgo.2020.06.023 [doi]
AB  - PURPOSE: Management of head and neck cancers (HNC) in older adults is a common 
      but challenging clinical scenario. We assess the impact of Stereotactic Body 
      Radiation Therapy (SBRT) on survival utilizing the Geriatric-8 (G8) 
      questionnaire. MATERIALS AND METHODS: 171 HNC patients, deemed medically unfit 
      for definitive treatment, were treated with SBRT +/- systemic therapy. G8 
      questionnaires were collected at baseline, at 4-6 weeks, and at 2-3 months 
      post-treatment. Patients were stratified according to their baseline G8 score: 
      <11 as 'vulnerable', 11-14 as 'intermediate', and >14 as 'fit'. Overall survival 
      (OS) was assessed through univariate Kaplan Meier analysis. Repeated measures 
      ANOVA was used to determine if baseline characteristics affected G8 score 
      changes. RESULTS: Median follow-up was seventeen months. 60% of patients 
      presented with recurrent HNC, 30% with untreated HNC primaries, and 10% with 
      metastatic non-HNC primaries. Median age was 75 years. Median Charlson 
      Comorbidity Index score was 2. 51% of patients were 'vulnerable', 37% were 
      'intermediate', and 12% were 'fit' at baseline, with median survival of 13.2, 
      24.3, and 41.0 months, respectively (p = .004). Patients who saw a decrease in 
      their follow-up G8 score (n = 69) had significantly lower survival than patients 
      who had stable or increased follow-up G8 scores (n = 102), with median survival 
      of 8.6 vs 36.0 months (p < .001). CONCLUSION: The G8 questionnaire may be a 
      useful tool in upfront treatment decision-making to predict prognosis and prevent 
      older patients from receiving inappropriate anti-cancer treatment. Decline in 
      follow-up G8 scores may also predict worse survival and aid in goals of care 
      following treatment.
CI  - Copyright (c) 2020 Elsevier Inc. All rights reserved.
FAU - Gogineni, Emile
AU  - Gogineni E
AD  - Department of Radiation Medicine, Northwell Health, Lake Success, NY, USA.
FAU - Rana, Zaker
AU  - Rana Z
AD  - Department of Radiation Medicine, Northwell Health, Lake Success, NY, USA.
FAU - Wotman, Michael
AU  - Wotman M
AD  - Department of Radiation Medicine, Northwell Health, Lake Success, NY, USA.
FAU - Karten, Jessie
AU  - Karten J
AD  - Department of Radiation Medicine, Northwell Health, Lake Success, NY, USA.
FAU - Riegel, Adam
AU  - Riegel A
AD  - Department of Radiation Medicine, Northwell Health, Lake Success, NY, USA.
FAU - Marrero, Mihaela
AU  - Marrero M
AD  - Department of Radiation Medicine, Northwell Health, Lake Success, NY, USA.
FAU - Maduro, Luis
AU  - Maduro L
AD  - Department of Radiation Medicine, Northwell Health, Lake Success, NY, USA.
FAU - Kamdar, Dev
AU  - Kamdar D
AD  - Department of Otolarygology, Head / Neck Surgery, Northwell Health, Lake Success, 
      NY, USA.
FAU - Frank, Douglas
AU  - Frank D
AD  - Department of Otolarygology, Head / Neck Surgery, Northwell Health, Lake Success, 
      NY, USA.
FAU - Paul, Doru
AU  - Paul D
AD  - Department of Medical Oncology, Northwell Health, Lake Success, NY, USA.
FAU - Seetharamu, Nagashree
AU  - Seetharamu N
AD  - Department of Medical Oncology, Northwell Health, Lake Success, NY, USA.
FAU - Ghaly, Maged
AU  - Ghaly M
AD  - Department of Radiation Medicine, Northwell Health, Lake Success, NY, USA. 
      Electronic address: mghaly@northwell.edu.
LA  - eng
PT  - Journal Article
DEP - 20200624
PL  - Netherlands
TA  - J Geriatr Oncol
JT  - Journal of geriatric oncology
JID - 101534770
SB  - IM
MH  - Aged
MH  - Geriatric Assessment
MH  - *Head and Neck Neoplasms/radiotherapy
MH  - Humans
MH  - Neoplasm Recurrence, Local
MH  - *Radiosurgery
MH  - Surveys and Questionnaires
OTO - NOTNLM
OT  - Cancer
OT  - Elderly
OT  - G8
OT  - Head neck
OT  - Older
OT  - Prognosis
OT  - Quality of life
OT  - SBRT
OT  - Screening tool
COIS- Declaration of Competing Interest Conflicts of interest: none.
EDAT- 2020/07/01 06:00
MHDA- 2021/07/29 06:00
CRDT- 2020/06/29 06:00
PHST- 2020/04/06 00:00 [received]
PHST- 2020/05/11 00:00 [revised]
PHST- 2020/06/18 00:00 [accepted]
PHST- 2020/07/01 06:00 [pubmed]
PHST- 2021/07/29 06:00 [medline]
PHST- 2020/06/29 06:00 [entrez]
AID - S1879-4068(20)30176-4 [pii]
AID - 10.1016/j.jgo.2020.06.023 [doi]
PST - ppublish
SO  - J Geriatr Oncol. 2021 Jan;12(1):122-127. doi: 10.1016/j.jgo.2020.06.023. Epub 
      2020 Jun 24.