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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

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Abstract
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 [Vulnerable Elders Survey-13 (VES-13), G8 and the Combined Screening Tool VES-13 + (17-G8)' or CST], the feasibility of serial CGA, and correlations with health-related quality of life evolution [HRQOL; European Organisation for Research and Treatment of Cancer Quality of Life Questionnaires (EORTC QLQ)-C30 and -HN35] 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, G8, 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, G8 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.
Keywords
head and neck cancer, comprehensive geriatric assessment, elderly, health-related quality of life, supportive care, curative treatment, MILD COGNITIVE IMPAIRMENT, RADIATION-THERAPY, SCREENING TOOL, OLDER PATIENTS, EUROPEAN-ORGANIZATION, CLINICAL-TRIALS, TASK-FORCE, ONCOLOGY, CHEMOTHERAPY, DISTRESS

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Chicago
Pottel, Lies, Michelle Lycke, Tom Boterberg, Hans Pottel, Laurence Goethals, Fréderic Duprez, Nele Van Den Noortgate, et al. 2014. “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.” European Journal of Cancer Care 23 (3): 401–412.
APA
Pottel, L., Lycke, M., Boterberg, T., Pottel, H., Goethals, L., Duprez, F., Van Den Noortgate, N., et al. (2014). 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. EUROPEAN JOURNAL OF CANCER CARE, 23(3), 401–412.
Vancouver
1.
Pottel L, Lycke M, Boterberg T, Pottel H, Goethals L, Duprez F, et al. 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. EUROPEAN JOURNAL OF CANCER CARE. 2014;23(3):401–12.
MLA
Pottel, Lies, Michelle Lycke, Tom Boterberg, et al. “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.” EUROPEAN JOURNAL OF CANCER CARE 23.3 (2014): 401–412. Print.
@article{4264358,
  abstract     = {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 [Vulnerable Elders Survey-13 (VES-13), G8 and the Combined Screening Tool VES-13 + (17-G8)' or CST], the feasibility of serial CGA, and correlations with health-related quality of life evolution [HRQOL; European Organisation for Research and Treatment of Cancer Quality of Life Questionnaires (EORTC QLQ)-C30 and -HN35] 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, G8, 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, G8 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.},
  author       = {Pottel, Lies and Lycke, Michelle and Boterberg, Tom and Pottel, Hans and Goethals, Laurence and Duprez, Fr{\'e}deric and Van Den Noortgate, Nele and De Neve, Wilfried and Rottey, Sylvie and Geldhof, Kurt and Buysse, Veronique and Kargar-Samani, K and Ghekiere, Veronique and Debruyne, Philip R},
  issn         = {0961-5423},
  journal      = {EUROPEAN JOURNAL OF CANCER CARE},
  keyword      = {head and neck cancer,comprehensive geriatric assessment,elderly,health-related quality of life,supportive care,curative treatment,MILD COGNITIVE IMPAIRMENT,RADIATION-THERAPY,SCREENING TOOL,OLDER PATIENTS,EUROPEAN-ORGANIZATION,CLINICAL-TRIALS,TASK-FORCE,ONCOLOGY,CHEMOTHERAPY,DISTRESS},
  language     = {eng},
  number       = {3},
  pages        = {401--412},
  title        = {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},
  url          = {http://dx.doi.org/10.1111/ecc.12179},
  volume       = {23},
  year         = {2014},
}

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