The Senior Oncology Clinic commenced in July 2015 at the Gold Coast University Hospital to provide a patient-centred multidisciplinary approach for senior oncology patients. Patients over 70 were reviewed by a multidisciplinary team who performed a series of validated geriatric assessments. The outcomes of these assessments were discussed and a treatment plan was proposed. Recent trials have suggested that comprehensive geriatric assessments may assist in predicting toxicity in an elderly population.
The objective of this audit was to assess treatment tolerability for patients assessed in the Senior Oncology Clinic compared to a control population.
After ethics approval, data were collected prospectively from the Senior Oncology Clinic (test) patients, and retrospectively from the general oncology (control) patients. Baseline characteristics included basic demographics, functional status, comorbidities and medications. Outcomes assessed included number treated, type of treatment, curative or palliative intent, dose delivery, grade 3+ toxicity, admissions due to toxicity, and treatment cessation due to toxicity.
There were 74 test patients and 75 control patients. The median age was 83 in both groups, the majority were male (53% vs. 56%) and they were well matched for comorbidities and medications. Fewer patients were treated in the test group compared to the control group (45% vs. 59%).
In the curative setting, patients in the test group received more chemotherapy (84% vs. 70%), had fewer admissions due to toxicity (38% vs 44%), and experienced less toxicity (23% vs. 33%).
In the palliative setting, test patients received more chemotherapy with less toxicity (31% vs. 33%) and were less likely to discontinue treatment due to toxicity (25% vs 44%), however they had more admissions due to toxicity (62.5% vs 44%).
Statistical analysis was not performed due to small numbers.
A comprehensive geriatric assessment may allow more appropriate tailoring of treatment for elderly patients.