Attention : notre hôpital est actuellement en travaux de modernisation pour toujours mieux vous soigner et vous accueillir. Certains accès sont fermés et des services ont changé d'adresse. Veillez à bien vérifier votre convocation avant de vous déplacer. Consulter le plan des différents sites
Effectiveness of Geriatric Assessment-Driven Interventions on Survival and Functional and Nutritional Status in Older Patients with Head and Neck Cancer: A Randomized Controlled Trial (EGeSOR).
Auteurs
Elena Paillaud
Lydia Brugel
Chloe Bertolus
Melany Baron
Emilie Bequignon
Philippe Caillet
Thomas Schouman
Jean Lacau Saint Guily
Sophie Périé
Eric Bouvard
Marie Laurent
Didier Salvan
Laurence Chaumette
Laure de Decker
Benoit Piot
Beatrix Barry
Agathe Raynaud-Simon
Elisabeth Sauvaget
Christine Bach
Antoine Bizard
Abderrahmane Bounar
Aurelien Minard
Bechara Aziz
Eric Chevalier
Dominique Chevalier
Cedric Gaxatte
Olivier Malard
Evelyne Liuu
Sandrine Lacour
Laetitia Gregoire
Charlotte Lafont
Florence Canouï-Poitrine
Source:
Journal (source)Cancers (Basel)
Publié le
Date de publication
Résumé
AbstractThis study assesses the efficacy of Geriatric Assessment (GA)-driven interventions and follow-up on six-month mortality, functional, and nutritional status in older patients with head and neck cancer (HNC). HNC patients aged 65 years or over were included between November 2013 and September 2018 by 15 Ear, Nose, and Throat (ENT) and maxillofacial surgery departments at 13 centers in France. The study was of an open-label, multicenter, randomized, controlled, and parallel-group design, with independent outcome assessments. The patients were randomized 1:1 to benefit from GA-driven interventions and follow-up versus standard of care. The interventions consisted in a pre-therapeutic GA, a standardized geriatric intervention, and follow-up, tailored to the cancer-treatment plan for 24 months. The primary outcome was a composite criterion including six-month mortality, functional impairment (fall in the Activities of Daily Living (ADL) score ≥2), and weight loss ≥10%. Among the patients included (n = 499), 475 were randomized to the experimental (n = 238) or control arm (n = 237). The median age was 75.3 years [70.4-81.9]; 69.5% were men, and the principal tumor site was oral cavity (43.9%). There were no statistically significant differences regarding the primary endpoint (n = 98 events; 41.0% in the experimental arm versus 90 (38.0%); p = 0.53), or for each criterion (i.e., death (31 (13%) versus 27 (11.4%); p = 0.48), weight loss of ≥10% (69 (29%) versus 65 (27.4%); p = 0.73) and fall in ADL score ≥2 (9 (3.8%) versus 13 (5.5%); p = 0.35)). In older patients with HNC, GA-driven interventions and follow-up failed to improve six-month overall survival, functional, and nutritional status.