RESUMO
BACKGROUND: Treatment advances offer options for cancer treatment in older adults that are less invasive and have fewer side effects. Geriatric assessment is a key component of treatment planning to identify functional and physiologic status and is the basis of decision making. OBJECTIVES: This article discusses the role of geriatric assessment, treatment options (e.g., surgical, chemotherapy, radiation therapy), survivorship issues, and palliative care strategies for older adults with cancer. METHODS: Literature was reviewed to identify geriatric assessment implications, current treatment strategies, and survivorship and palliative care interventions for older adults with cancer based on a case study approach. FINDINGS: Geriatric assessment is key to identifying deficits and disabilities in older adults with cancer and is a critical component in oncology treatment planning. Evidence-based, less invasive treatment options are available and offer older adults more tolerable oncologic therapies.
Assuntos
Avaliação Geriátrica/métodos , Enfermagem Geriátrica/organização & administração , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/terapia , Cuidados Paliativos/métodos , Idoso , Idoso de 80 Anos ou mais , Quimiorradioterapia Adjuvante , Terapia Combinada , Medicina Baseada em Evidências , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico , Masculino , Equipe de Assistência ao Paciente/organização & administração , Pneumonectomia/métodos , Prognóstico , Medição de Risco , Análise de Sobrevida , SobrevivênciaAssuntos
Efeitos Psicossociais da Doença , Avaliação Geriátrica , Custos de Cuidados de Saúde , Neoplasias/economia , Neoplasias/terapia , Qualidade de Vida , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Custos de Cuidados de Saúde/tendências , Humanos , Assistência Centrada no Paciente , Prevalência , Estados UnidosRESUMO
BACKGROUND: The clinical trials on which the treatment of advanced colorectal (CRC) is based enroll few elderly patients. Furthermore, few investigations have determined the use and outcomes of the treatment of advanced CRC in practice. This study evaluated the treatment of advanced CRC in community oncology practices, focusing on age-related differences in treatment and outcome. METHODS: A national, retrospective chart review was conducted to evaluate the management of advanced CRC in 10 community practices across the U.S. All medical records of patients diagnosed with advanced CRC initiating chemotherapy treatment after January 1, 2003 through 2006 were included. The primary aim was to compare the proportion receiving doublet chemotherapy (irinotecan or oxaliplatin with a fluoropyrimidine) as initial therapy in young (age
Assuntos
Anticorpos Monoclonais/administração & dosagem , Antineoplásicos/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/patologia , Fatores Etários , Idoso , Camptotecina/administração & dosagem , Camptotecina/análogos & derivados , Feminino , Humanos , Irinotecano , Masculino , Estadiamento de Neoplasias , Compostos Organoplatínicos/administração & dosagem , Oxaliplatina , Estudos Retrospectivos , Resultado do TratamentoAssuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Ensaios Clínicos como Assunto , Neoplasias Colorretais/tratamento farmacológico , Avaliação Geriátrica , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Neoplasias Colorretais/patologia , Aprovação de Drogas , Geriatria , Humanos , Oncologia , Estados Unidos , United States Food and Drug AdministrationRESUMO
Attention Deficit Hyperactivity Disorder (ADHD) is seen in the majority of children with Fragile X Syndrome (FraX). Previous work has documented an enhanced sweat response to stimuli in children with FraX compared to controls utilizing electrodermal response (EDR) measures. The present study assesses the EDRs both on and off stimulants in 19 children with ADHD and FraX compared to 17 age- and IQ-matched control patients with ADHD and developmental delays. Although the baseline EDRs were comparable between FraX patients and controls, the patients with FraX had a significant decrease in EDR amplitude and number of peaks when treated with stimulants compared to controls. This suggests that patients with FraX are more responsive to the enhancement of inhibitory systems that occur with stimulant use for ADHD. The use of a quantifiable measure, such as EDR, is recommended in future studies of treatment efficacy.