Health-related quality of life with comprehensive geriatric assessment guided care versus usual care in older adults with cancer: A systematic review and meta-analysis of randomized trials

Zhi Xuan Ng; Pooja Handa; Huili Zheng; Matthew Zhixuan Chen; Yu Yang Soon; Prunella Blinman; Martin Stockler; Francis Ho

doi:10.1016/j.critrevonc.2024.104442

Health-related quality of life with comprehensive geriatric assessment guided care versus usual care in older adults with cancer: A systematic review and meta-analysis of randomized trials

Crit Rev Oncol Hematol. 2024 Sep:201:104442. doi: 10.1016/j.critrevonc.2024.104442. Epub 2024 Jul 16.

Authors

Zhi Xuan Ng¹, Pooja Handa¹, Huili Zheng², Matthew Zhixuan Chen³, Yu Yang Soon⁴, Prunella Blinman⁵, Martin Stockler⁶, Francis Ho⁷

Affiliations

¹ Department of Radiation Oncology, National University Cancer Institute, Singapore, Singapore.
² Clinical Research Unit, Khoo Teck Puat Hospital, Singapore.
³ Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
⁴ Department of Radiation Oncology, National University Cancer Institute, Singapore, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia. Electronic address: [email protected].
⁵ Department of Medical Oncology, Concord Repatriation General Hospital, Sydney, NSW, Australia.
⁶ NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia; Department of Medical Oncology, Concord Repatriation General Hospital, Sydney, NSW, Australia; Department of Medical Oncology, Chris O'Brien Lifehouse, Sydney, NSW, Australia.
⁷ Department of Radiation Oncology, National University Cancer Institute, Singapore, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

PMID: 39002788
DOI: 10.1016/j.critrevonc.2024.104442

Abstract

Background: To evaluate if comprehensive geriatric assessment (CGA)-guided care improves health-related quality of life (HRQL) in older adults with cancer compared to usual care.

Methods: Relevant randomized controlled trials (RCTs) were identified through biomedical databases. Meta-analyses using DerSimonian-Laird model summarized the difference in the mean change of HRQL scores from baseline across various time points, with evidence certainty assessed by the GRADE tool. Logistic regression via generalized estimating equations analyzed predictors of HRQL improvement.

Results: Potential improvement in the global HRQL score by CGA-guided care at 3 months (Cohen's d 0.27, 95 % CI -0.03-0.58, moderate certainty), could not be excluded. Larger RCTs or those mandating CGA before initiating anti-cancer treatment were predictors of improved HRQL.

Conclusion: The effects of CGA-guided care on HRQL were variable. Larger RCTs and those mandating pre-treatment CGA tended to report improved HRQL.

Keywords: Comprehensive Geriatric Assessment; Geriatric Oncology; Health-related quality of life; Randomized trials.

Publication types

Comparative Study
Meta-Analysis
Review
Systematic Review

MeSH terms

Aged
Aged, 80 and over
Geriatric Assessment* / methods
Humans
Neoplasms* / drug therapy
Neoplasms* / psychology
Neoplasms* / therapy
Quality of Life*
Randomized Controlled Trials as Topic*