Background: Given population ageing understanding the impact of geriatric assessment on radiotherapy referrals for older people with newly diagnosed or recurrent cancers. This systematic review aims to assess the effect of geriatric assessment (GA) with tailored interventions or comprehensive geriatric assessment (CGA) compared to usual care for older adults with cancer receiving radiotherapy, and the impact on treatment decisions, care received, cancer-related and geriatric assessment outcomes.
Method: MEDLINE, EMBASE, CINAHL and PubMed were systematically searched for randomised control trials and prospective cohort studies with comparison groups from January 2000 to November 2022, focused on assessing the effect of GA/CGA compared to usual care on treatment decision-making, supportive care received, and cancer-related and geriatric assessment outcomes for older adults with cancer receiving radiotherapy.
Results: The search yielded 10,438 citations, with 119 flagged for full-text review. Only one randomised controlled trial was included, with older adults receiving radiotherapy for non-small cell lung cancer. Medical or non-medical interventions were implemented after CGA in 86% of patients. No statistically significant difference was reported between CGA and usual care at twelve months, for health-related quality of life [EuroQoL Group 5D health index, 0.77 vs. 0.71; Visual Analogue Scale, 69 vs. 66], overall survival [92% vs. 72%, p = 0.32], unplanned admission [46% vs.52%], or median length of stay [5.5 vs. 5, p = 0.62].
Conclusion: Larger comparative studies are required to determine whether integrating GA/CGA into care of older adults receiving radiotherapy can optimise treatment decisions and supportive care, thereby improving health-related quality of life, survival and adverse effects.