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<p>The increasing prevalence of cancer among older adults underscores the need for individualized therapy approaches. Chronological age alone is insufficient to guide oncological decision-making, as comorbidities, frailty, and functional status vary widely across patients. Risk assessments offer a structured method for evaluating the multidimensional health status of older patients with cancer, encompassing physical, psychological, cognitive, nutritional, and social domains. While a comprehensive geriatric assessment (CGA) remains the gold standard, it is time-intensive. Therefore, screening tools can help identify patients who would benefit most from full evaluation. The Practical Geriatric Assessment (PGA) provides a feasible, validated, and resource-efficient alternative. Tools such as the Cancer Aging Research Group (CARG) score and the Chemotherapy Risk Assessment Scale for High-Age Patients (CRASH) further aid in predicting chemotherapy-related toxicities more accurately than conventional indices. Implementing GA-driven management can reduce treatment-related toxicity, improve adherence, and enhance quality of life, although mortality benefits remain unproven. Integrating risk assessments into routine oncology practice represents a pragmatic,&#xa0;evidence-based approach to personalizing cancer therapy for older adults. Even a brief&#xa0;assessment can meaningfully influence outcomes, enabling oncologists to balance efficacy, tolerability, and quality of life—ultimately ensuring that the best supportive care begins before therapy starts.</p>

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Assessing frailty-related risk in older patients in hematology and oncology

  • 期刊论文

  • 发表日期：

    2026年2月11日

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  • Frédéric H. Witte

摘要

The increasing prevalence of cancer among older adults underscores the need for individualized therapy approaches. Chronological age alone is insufficient to guide oncological decision-making, as comorbidities, frailty, and functional status vary widely across patients. Risk assessments offer a structured method for evaluating the multidimensional health status of older patients with cancer, encompassing physical, psychological, cognitive, nutritional, and social domains. While a comprehensive geriatric assessment (CGA) remains the gold standard, it is time-intensive. Therefore, screening tools can help identify patients who would benefit most from full evaluation. The Practical Geriatric Assessment (PGA) provides a feasible, validated, and resource-efficient alternative. Tools such as the Cancer Aging Research Group (CARG) score and the Chemotherapy Risk Assessment Scale for High-Age Patients (CRASH) further aid in predicting chemotherapy-related toxicities more accurately than conventional indices. Implementing GA-driven management can reduce treatment-related toxicity, improve adherence, and enhance quality of life, although mortality benefits remain unproven. Integrating risk assessments into routine oncology practice represents a pragmatic, evidence-based approach to personalizing cancer therapy for older adults. Even a brief assessment can meaningfully influence outcomes, enabling oncologists to balance efficacy, tolerability, and quality of life—ultimately ensuring that the best supportive care begins before therapy starts.