61 P - Comprehensive geriatric assessment: a new approach to assess the global health status of elderly patients with cancer to be entered in clinical trials

Abstract

Aging is one of the most important risk factor for cancer. Despite in western countries nearly 60% of all tumours occurs in individuals aged 65 years or more, data from clinical research on elderly are scanty because older patients tend to be excluded from cancer clinical trials. This trend is particularly evident in lymphoproliferative diseases; for this reason the treatment of leukemia and lymphoma in the elderly has not achieved the same results as in younger patients. In addition to cancer, elderly are very often affected by concomitant chronic diseases, functional limitations and they are more vulnerable to iatrogenesis. They also are often socially isolated and economically deprived. Many Authors have stressed the limits of P.S. evaluation and the need of a practical tool to completely evaluate health status of elderly cancer patients. With the aim to provide a baseline picture of the main parameters that may contribute to identify subsets of elderly patients for clinical trial entry we created a Multidimensional Assesment Protocol for Cancer in Elderly (MACE) that collected information on socio-economic status, depression, physical performance and disability. Information on psycho-physical health condition is collected by Mini-Mental State Evaluation, Geriatric Depression Scale, Physical Performance Test, while social context and functional status is collected by Activity of Daily Living and Instrumental Activity of Daily Living questionnaire. The validation was performed by testing the MACE compared to the Sickness Impact Profile on thirty consecutive elderly patients with solid or hematological tumours, three times a week by two different physicians. The analysis indicates that this structured evaluation of functional status is feasible and reliable.