Can Geriatric Assessment Predict Oncology Outcomes?

背景：60%的癌症和70%的癌症死亡率发生在65岁以上的人群中。随着人口老龄化，肿瘤学家需要开发一种方法来表征老年癌症患者的“功能年龄”，以便根据除实足年龄以外的因素定制治疗决策和分层结果，并开发干预措施以优化癌症治疗。假设：可以制定老年癌症患者的老年仪器，以确定预测癌症治疗发病率和死亡率的独立于年龄的因素，并导致合理的干预措施，以优化肿瘤护理。具体目的：1)确定新开发的用于老年癌症患者的老年医学仪器的普遍可行性和心理测量学特性；2)评估老年仪器预测哪些老年患者更容易受到化疗毒性的能力；3)通过具体干预措施确定老年器械对临床护理和总体结果的影响。职业发展：通过这项工作，候选人将融合她之前在老年病学和肿瘤学方面的培训，并发展在老年肿瘤学领域独立研究所需的技能。计划在临床试验设计、生物统计学和测量发展方面进行为期五年的教学课程。候选人将由肿瘤学（George Bosl博士，导师）、老年病学（Mark Lachs博士，联合导师）、社会心理研究（Alice Kornblith博士，顾问）和生物统计学（Katherine Panageas博士和Bercedis Peterson博士，合作者）领域的专家进行指导。通过这项职业发展奖励，申请人将获得从事老年肿瘤学独立研究工作所需的技能。通过这项资助，候选人的目标是进一步了解老年肿瘤学，从而提高美国老年癌症患者的健康和独立性以及生活质量。

DESCRIPTION (provided by applicant): BACKGROUND: Sixty percent of all cancer and seventy percent of cancer mortality occurs in people over age 65. As the population ages, there is an emerging need to develop a means for oncologists to characterize the "functional age" of older patients with cancer in order to tailor treatment decisions and stratify outcomes based on factors other than chronological age and to develop interventions to optimize cancer treatment. HYPOTHESIS: A geriatric instrument for older patients with cancer can be formulated to identify factors independent of age that predict cancer treatment morbidity and mortality and result in rationale interventions to optimize oncologic care. SPECIFIC AIMS: 1) To determine the generalized feasibility and psychometric properties of a newly developed geriatric instrument for older patients with cancer; 2) To assess the geriatric instrument's ability to predict which older patients are more vulnerable to toxicity from chemotherapy; and 3) To determine the impact of the geriatric instrument on clinical care and overall outcomes through specific interventions. CAREER DEVELOPMENT: Through this work, the candidate will meld her previous training in geriatrics and oncology and develop the skills needed to develop an independent research career in geriatric oncology. Five years of didactic coursework in clinical trial design, biostatistics, and measurement development are planned. The candidate will be mentored by experts in the fields of oncology (Dr. George Bosl, Mentor), geriatrics (Dr. Mark Lachs, Co-Mentor), psychosocial research (Dr. Alice Kornblith, Advisor), and biostatistics (Dr. Katherine Panageas and Dr. Bercedis Peterson, collaborators). Through this career development award, the applicant will acquire the skills necessary to pursue an independent research career in geriatric oncology. Through the support of this grant, the candidate aims to further knowledge about geriatric oncology, and thus enhance the health and independence as well as the quality of life of older Americans with cancer.